About what diabetes is, perhaps, it is not necessary to speak. We all know about this disease, and some, unfortunately, know firsthand about it. But how does this pathology differ from diabetes insipidus? Symptoms and treatment of this disease will be discussed later in the article.
What is the specificity of the disease?
In a he althy person, blood sugar is neutralized with the help of the hormone insulin, which is produced by the pancreas - these are the features of physiology. However, if there is not enough of it or the tissues of the kidneys have lost sensitivity to its effects, the concentration of sugar in the blood rises, which then passes into the urine.
An interesting nuance: the word "diabetes" in Latin diabetes mellitus means "passing by." Doctors who helped people in the Renaissance (XIX century) did not have modern clinical and laboratory tools, and therefore were forced to draw up a conclusion, tasting the patient's urine. This is probably one of the reasons why going to a registered doctor has always cost a lot of money in those days.times.
Thus, one of the symptoms of diabetes insipidus in men and women can be considered the presence of glucose in the urine, and the second - polyuria. The medical term refers to the increased volume of urinary fluid released over a 24-hour period. By the way, the second name of the disease is “diabetes insipidus.”
Etiology of disease
All symptoms of diabetes insipidus are based on the main clinical manifestation of the disease - the loss of the ability of the kidneys to concentrate urine. This is an endocrine disorder that occurs as a result of a deficiency of antidiuretic hormone. The main signs that make it possible to suspect diabetes insipidus are:
- excruciating thirst all day and night;
- excessive "watery" urine.
To be fair, the natural rate of primary urine production in a he althy person is approximately 90-100 ml per minute. Following this logic, in an hour we should have about 6 liters of natural biological fluid! However, almost all of this urine is reabsorbed into the renal tubules. This function is regulated by antidiuretic hormone, which is produced by the pituitary gland. It is this substance that plays a major role in water-s alt metabolism.
The frequency of diagnosing this disease is the same for everyone. There are symptoms of diabetes insipidus in children and adults, regardless of gender. The risk group is predominantly young people aged 20-35.
Central disease
There are two types of diabetes insipidus - central and peripheral. In the first case, we are talking about malfunctions in the brain, which for some reason does not produce antidiuretic hormone. As a rule, central diabetes insipidus is a secondary disease in more serious pathologies:
- cancerous and non-malignant tumors of the pituitary and hypothalamus;
- impaired blood supply to the pituitary and hypothalamus due to an ischemic stroke;
- formation of post-traumatic fibrocystic tissues in the pituitary gland;
- foci of metastasis in the hypothalamic-pituitary system;
- post-infectious syndrome.
The last factor can provoke the appearance of symptoms of diabetes insipidus after a severe infection (flu, SARS, herpes, measles, chickenpox, scarlet fever, syphilis, etc.).
Peripheral type diabetes
This is the second form of the disease. Another name is also known - nephrogenic diabetes insipidus. This disease develops due to kidney dysfunction. In the nephrogenic form, the brain and endocrine glands produce a sufficient amount of an antidiuretic substance, but the excretory system of the body does not perceive its effect. Accordingly, the primary excreted urine is not absorbed, its amount is not reduced.
Pregnant women
By the way, doctors conditionally allocate andthe third form of diabetes insipidus, originating from the peripheral. It can occur during pregnancy, but in most cases resolves without intervention after childbirth or towards the end of the gestation period. Its development is associated with placental enzymes that can destroy antidiuretic hormone molecules, which leads to its inefficiency.
The causes of diabetes insipidus in women need no further explanation. The symptoms of this nephrogenic form of diabetes are due to unstable kidney function, which can be caused by:
- congenital anomalies and infection of the medulla of the organ;
- glomerulonephritis;
- anemia;
- polycystic renal disease and amyloidosis;
- chronic renal failure;
- prolonged damage to tissues by toxins (due to abuse of alcohol, drugs).
It is impossible to ignore the fact that diffuse lesions of both organs play a role in the development of peripheral diabetes insipidus. In the presence of at least one he althy kidney, which has a full blood supply and urination, there are no disturbances in diuresis.
Cryptogenic diabetes
In the case histories of elderly patients, experts often point to a cryptogenic form of diabetes insipidus. The symptoms of such a disease, as a rule, do not differ significantly from the central or peripheral type of the disease. The frequency of diagnosing such a diagnosis is extremely high - up to 30%. A favorable background for the development and course of cryptogenic diabetes insipidus aremultiple endocrine disorders.
Clinical picture
So, the symptoms of diabetes insipidus in women are no different from the manifestations of the disease in the male part of the population. Antidiuretic hormone is found in each of us in the same concentration, regardless of gender.
However, the consequences of the development of the disease in the fairer sex may differ. Lack of timely treatment of the symptoms of diabetes insipidus in women can lead to infertility. As the pathology progresses, there are violations of the ovulation-menstrual cycle, amenorrhea. The severity of clinical manifestations is determined by two factors:
- blood levels of estrogen and antidiuretic hormone;
- susceptibility to it of receptors located in the renal parenchyma.
Against the background of the lack of normal receptor susceptibility and insufficient production of hormones, the symptoms of the disease become maximally pronounced. The main symptoms of diabetes insipidus in women, however, as in men, are:
- constant debilitating thirst;
- frequent and profuse urination.
The daily volume of fluid excreted by the body in severe forms of the disease can reach 25 liters. Consequently, no excretory system is able to cope with such a load. It is quite natural that the compensatory capabilities of the body against the background of a progressive disease are depleted. This becomes the reasonappearance of secondary symptoms of diabetes insipidus. They consider them to be:
- dry mouth and mucous membranes;
- sore throat;
- lack of natural moisture of the epidermis;
- rapid weight loss;
- development of enuresis at night (the result of a weakening of the sphincter of the bladder due to increased stress);
- weakness and decreased performance;
- omission and stretching of the walls of the stomach (gastroptosis).
Probable Complications
Due to tissue dehydration and a colossal water load in the intestinal lumen, indigestion and dysbacteriosis may develop, malfunctions occur in the production of bile, gastric and pancreatic juice. The intake of large amounts of water leads to stretching of the ureters and bladder. Men with diabetes insipidus mostly suffer from excessive sweating.
Treatment of symptoms caused by exsicosis (dehydration of the body) should not be delayed until later. Regular fluid loss leads to heart rhythm disturbances and low blood pressure. In patients who have long suffered from diabetes insipidus, the blood becomes abnormally thick, leading to thrombosis and, as a result, heart attacks and strokes. Thus, the constant pumping of large volumes of water in the body greatly depletes the patient.
Illness at an early age
The symptoms of diabetes insipidus in children are difficult to recognize. Pathology is especially dangerous for babies - the bodies of babies are very quickly dehydrated. From breastfeedingmilk, a child with diabetes insipidus refuses, instead of it, he greedily drinks only water. But, unfortunately, parents do not always guess what the matter is, and try to feed the baby, who simply cannot tell about his excruciating thirst. In infants suffering from this ailment, the days go by. Without timely therapy, the child dies.
Parents should be alert to the following symptoms of diabetes insipidus in a baby under one year old:
- cry without tears;
- retraction of the fontanel;
- weak, barely audible voice;
- convulsions;
- half-faint.
There is little information about the causes of this disease in children. Experts believe that the pathology is inherited or is the result of abnormal intrauterine formation of the central nervous system.
Diagnosis of diabetes insipidus
It is not difficult to identify diseases in the majority of cases by symptoms. And yet, on the basis of the patient's complaints and the pronounced clinical picture alone, the doctor is not able to establish a diagnosis and has no right to prescribe treatment. To confirm the pathology, it is necessary to determine the level of antidiuretic hormone in the blood, to examine the performance of the kidneys. It is important to understand that establishing a diagnosis is only half the battle, finding the provoking factor is a much more difficult task.
Diagnosis for symptoms of diabetes insipidus in women and men is a set of mandatoryresearch procedures, which includes:
- MRI;
- angiography of cerebral vessels;
- tests that determine the level of hormones;
- urography and ultrasound of the kidneys;
- study of ions, osmolarity of electrolytes in blood plasma and urine.
Treatment
In a mild form of diabetes insipidus, the elimination of the cause naturally leads to the disappearance of clinical manifestations. If the diagnosis did not allow obtaining information about the causes of the disease, while the daily volume of urine excreted does not exceed 3-4 liters, it is recommended to adjust the diet and drinking regimen.
Severe diabetes insipidus, characterized by a sharp decrease in the level of an antidiuretic substance in the blood, requires replacement therapy with desmopressin, a synthetic analogue of the natural hormone. In pharmacy sales, this drug is better known as Minirin, it is available in tablet form.
Since the rate of the presence of the hormone directly depends on its deficiency, during the first week of treatment, an individual selection of the dose is carried out, which is gradually increased until the patient feels satisfactory. Minirin is usually taken three times a day.
In the central forms of diabetes insipidus, therapy is carried out with the help of drugs that stimulate the secretion of the hormone. The most famous is the drug Miscleron. To combat seizuresuse "Carbamazepine".
In the case of a peripheral form of pathology, complex treatment is required. Patients are prescribed drugs from the group of non-steroidal anti-inflammatory drugs and cytostatics. Minimizing s alt and sugar intake is essential.
Prognosis and chances of recovery
Diabetes insipidus is a typical disease requiring lifelong monitoring and maintenance medications. The likelihood of a complete cure increases when the causative factor is identified and eliminated.
