• Non-diabetes mellitus: symptoms, treatment, causes, symptoms

    What it is? Non-diabetes is an endocrine disease associated with impaired functioning of the pituitary and / or hypothalamus.

    Occurs rarely: approximately 100,000 people have 3 cases of the same frequency in men and women. Age of the diseased from 25 to 50 years.

    Causes of the disease

    Why does diabetes insipidus develop, and what is it? One of the functions of the hypothalamus is the regulation of the secretion of two important hormones: oxytocin and vasopressin( antidiuretic hormone).The main role of the last hormone is in the reverse absorption( resorption) of water by the kidneys.

    The place of temporary storage of hormones after their secretion is the pituitary gland. It is from this, as necessary, vasopressin and other hormones are released into the bloodstream. Deficiency of vasopressin is accompanied by a violation of water absorption in the kidneys, which leads to the manifestation of symptoms of the disease, reminiscent of the symptoms of diabetes, which is also characterized by diabetes, thirst.

    Another cause of diabetes insipidus is the immunity of kidney tissues to the effect of this hormone. Contributing factors:

    • trauma to the skull;
    • brain tumors affecting the hypothalamus and pituitary gland;
    • complications arising in the early period after the operation on the brain;
    • hereditary predisposition;
    • encephalitis;
    • syphilis;
    • is an anemia of rare form;
    • metastases;
    • kidney disease( multiple cysts, amyloidosis, etc.)
    In 30% of cases the causes of the disease remain unknown.

    Symptoms of diabetes insipidus

    For diabetes insipidus, the characters are the following symptoms that you should pay attention to:

    1. 1) A constant thirst and fluid intake is more than the recommended daily volume( at a rate of 1, 5 - 2 liters).And preference is given to cool water from the tap;
    2. 2) Abundant urination( polyuria) from 3 to 10 liters per day, mainly at night. Food containing a large amount of salt contributes to polyuria;
    3. 3) In connection with loss of fluid( dehydration), dry skin, seizures;
    4. 4) Appearance of nausea and vomiting;
    5. 5) Reduced sweating;
    6. 6) Changes in the nervous and emotional sphere: decreased mental activity, insomnia, emotional lability, etc.;
    7. 7) Elevated diuresis may affect blood pressure and heart function;
    8. 8) The disease adversely affects libido and potency.

    Classification of the disease

    There are following types of diabetes insipidus:

    1. 1) Renal type of diabetes - accompanied by a change in the perception of the hormone by the kidney cells, while the level of vasopressin is within normal limits;
    2. 2) Central type of diabetes - characterized by a violation of the synthesis of vasopressin in the cells of the hypothalamus;
    3. 3) Diabetes of pregnant women occurs due to the destruction of vasopressin by placenta enzymes. The disease occurs immediately after the birth of the child;
    The course of the disease depends on the primary or secondary form. Primary( idiopathic) form of the disease is characterized by pituitary insufficiency without noticeable during the examination of its anatomical changes.

    In the secondary form, changes in the structure of the pituitary gland( due to tumor compression, during the post-traumatic period, etc.) are visible, which are manifested by vomiting, headaches, increased CSF pressure, etc.

    Diagnosis of diabetes insipidus

    The clinical picture of the disease does not complicate the diagnosis. Patients in consciousness note an acute onset with an unquenchable thirst and abundant diabetes.

    In patients without consciousness, the onset of the disease is complicated by hyperosmolarity and dehydration due to the inability to independently and timely quench thirst. Hyperosmolarity is characterized by an elevated sodium content in the blood, a decrease in intravascular volume, and dehydration.

    Supplement clinical symptoms of diabetes insipidus and laboratory tests of urine( according to Zimnitsky, a general analysis), blood. The density of urine is in the range 1001 - 1004 at a rate of 1010 - 1025. In the blood test, the number of erythrocytes and the dry residue increase.

    Of the instrumental methods of great value are: magnetic resonance imaging of the brain( for determining the type of diabetes insipidus).Sufficiently informative is a sample with dryness, which is conducted in the daytime, starting at 8 am. Precedes the sample of emptying the bladder.

    After this, each hour of the patient is weighed and the specific gravity of the extracted urine is determined, as well as the concentration of sodium in the blood. After 6-8 hours, the patient is injected with desmopressin, after which blood and urine are taken and the doctor evaluates the result of the test. An alternative to a sample with dryness is a sample with metirapone.

    Differential diagnosis of

    Diabetes insipidus should be distinguished from the following diseases that have similar symptoms:

    1. 1) Hypertrophy of the prostate is a disease in which the prostate gland is enlarged. It is characterized by frequent urination mostly at night. In addition, the following symptoms are characteristic: a flaccid jet of urine, a sensation of a full bladder after the act of urination;
    2. 2) Azotemia - an increase in the content of nitrogenous substances in the blood. Similar symptoms with diabetes insipidus are thirst, dry mouth;
    3. 3) Diabetes mellitus is an endocrine disease caused by insufficiency( absolute or relative) of insulin.
    Symptoms that are similar to diabetes insipid include: dry skin, polydipsia( thirst), polyuria.

    Treatment of diabetes insipidus

    Non-diabetes mellitus, the most effective way of treatment is pathogenetic therapy( which affects the development mechanism), which consists in the introduction of antidiuretic hormone. It is available in the form of powder and solution. The disease caused by the tumor is successfully treated.

    After surgery, X-ray therapy of hormonal therapy, as a rule, recovery occurs. Symptomatic treatment consists in prescribing drugs that affect the nervous system( bromine, valerian).

    In patients with nephrogenic diabetes, non-steroidal anti-inflammatory drugs and thiazide diuretics are prescribed. Of great importance in the recovery is nutrition, which should include products containing little salt.

    Complications and prognosis

    Prolonged polyuria can cause kidney failure, hydronephrosis, enlargement of renal tubules, and cerebral edema.

    The prognosis of diabetes insipidus largely depends on the cause. Non-diabetes mellitus does not affect the performance and life expectancy, but it reduces its quality. Recovery comes after removal of the tumor, successful therapy of tuberculosis, malaria, syphilis, etc.

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