September 30, 2022

The Lesser-Known Type Of Diabetes

Diabetes

Introduction

Almost everyone is aware of the chronic condition called diabetes. It occurs due to abnormal blood glucose levels caused by insufficiency of the insulin hormone. But this refers to just one kind of diabetes, namely diabetes mellitus (type 2 diabetes). There is another rare form of diabetes, which is called diabetes insipidus. Let us find out more about this condition.

Why is it essential to recognise diabetes symptoms early?

An early diagnosis allows the individual to start treatment sooner, which prevents aggravating the already existing diabetes symptoms. Taking care of one’s diet and making lifestyle changes ahead of schedule help manage blood sugar levels better.

What are the symptoms of diabetes insipidus?

The signs and symptoms include:

  • Extreme thirst
  • Excessive amounts of insipid, colourless, and odourless urine
  • Frequent urination
  • Muscle pain
  • General weakness
  • Feeling of nausea
  • Dehydration

Differences between diabetes insipidus and type 2 diabetes symptoms

Symptoms Causes (Diabetes insipidus) Causes (Type 2 diabetes)

  1. Fatigue and exhaustion
Low electrolytic balance due to frequent urination Too high or too low blood sugar levels

  1. Excessive thirst
Loss of fluids High concentration of glucose

  1. Hazy or blurred vision
Dehydration High glucose volumes cause the eye lens to swell

What causes diabetes insipidus?

The hypothalamus of the pituitary gland secretes a hormone called vasopressin or anti-diuretic hormone (ADH). This hormone controls the amount of fluid reabsorbed by the kidneys. Insufficient ADH is produced, because of which the kidneys fail to reabsorb water. This excess water is excreted in the form of urine.

Types of diabetes insipidus

  • Central
    Damage to the pituitary gland or hypothalamus results in the faulty secretion of ADH. This causes the kidneys to excrete more water than required, leading to frequent urination and incontinence.
  • Nephrogenic
    This condition is primarily due to a diseased kidney or genetic and structural defects. The kidneys cannot respond correctly to the ADH and fail to reabsorb the required quantity of water.
  • Gestational
    This is a rare condition seen only in pregnant women. The placenta’s enzymatic reactions break down the vasopressin, causing the symptoms to arise. The effects usually go away post delivery.
  • Dipsogenic
    The thirst-regulating centre in the hypothalamus may get damaged, resulting in the urge to drink excessive fluids. This action results in frequent urination. The urine itself is highly diluted.

Who is more likely to get diabetes insipidus?

Individuals with the following conditions are at high risk:

  • Those having a family history of the condition
  • Those who have suffered a severe head trauma
  • Those having metabolic disorders such as hypercalcemia
  • Those who take kidney-related medications like diuretics

Diagnosis

Proper investigation is essential to decide on the correct line of treatment. The tests conducted to detect diabetes insipidus include:

  • Blood tests
    Sodium and potassium levels in the blood act as indicators. The vasopressin hormone level in the blood is also checked.
  • Urine analysis
    High levels of dilution in the urine are an indicator of this condition. The water content in urine is usually high, while the salt and waste concentration is low.
  • Fluid deprivation test
    No liquids must be consumed for several hours to check the body’s response. If frequent and excessive urination (diluted urine formation) persists, it indicates diabetes insipidus.
  • Vasopressin stimulation test
    This test determines whether the condition is central or nephrogenic diabetes insipidus. It involves the administration of vasopressin hormone to check how the body reacts to it.
  • Magnetic resonance imaging (MRI)
    Computer-generated radiowaves and magnetic fields are employed to take detailed images of the brain and hypothalamus. This helps determine if any injury or trauma is causing the suppression of ADH secretion.

How can diabetes insipidus be treated?

  • For central and gestational diabetes insipidus, the treatment is administering desmopressin (a hormone similar to vasopressin) as an injection, a pill, or nasal spray.
  • For nephrogenic diabetes insipidus, diuretic medicine combinations are prescribed to reduce the amount of urine formation.
  • For dipsogenic diabetes insipidus, therapy along with diuretics is the recommended treatment.

What is the prognosis for diabetes insipidus?

Though it is a chronic condition that cannot be wholly cured, its symptoms can be handled well. Drinking enough water and a low-salt diet are crucial ways to manage the situation.

Conclusion

This uncommon diabetic condition affects 1 in 25,000 people in the general population. Although the diabetes symptoms and complications of this type are less severe than that of diabetes mellitus, proper care must be taken not to aggravate the condition. Children and senior citizens are at greater risk of developing complications because of this condition.

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