Hello everyone! My name is Chak Lon Kuang,
and today I am gonna present Diabetes Insipidus. So What is Diabetes?
It literally means a large amount of water goes through, since dia- is a prefix means
through, and betes is the suffix means to go.
Medically speaking it is a general term for disease charaterized by excessive discharge
of urine. There’s no main types of diabetes: Diabetes
mellitus and Diabetes Insipidus. Diabetes Mellitus is a disorder characterized
by abnormally high blood sugar level, which causes glycosuria,which is glucose within
urine. Mellitus by the way means sweet.
Diabetes insipidus is a disorder characterized by abnormal high amount of urine with no taste. Cause of Diabetes insipidus. The main cause
of it is that the reabsorption mechanism within the kidney is not functioning properly.
The picture on the right shows that fluid is not able to reabsorb back to the blood
vessels during the formation of urine. This causes the urine to be severely diluted.
There are two main causes for the reabsorption to go wrong, which leads to two types of DI.
The first type is a lack or low level of Antidiuretic Hormone.
And the other one is due the failure for kidney to respond to the Antidiuretic Hormone. One type of DI is known as central Diabetes
Insipidus. It is characterized by the lack or low level
of Antidiuretic Hormone. So what is Antidiuretic Hormone.
It’s also called Vasopressin. It is a hormone produced by the Hypothalamus
in the brain, stored and released by the pituitary gland.
Its main function is to stimulate the reabsorption of water by the renal tubules.
And now the reabosorption is hindered by low level or complete lack of ADH, which causes
excessive loss of water through urine. And the main cause for this is due to
the damage of Hypothalamus or pituitary gland by surguries,imflammation, tumor, etc.
And the disease may also be genetic. The other type of DI is known as Nephrogenic
Diabetes Insipidus It is characterized by the failure of the
kidney to respond to ADH, as shown by the figure on the right.
As a result, reabsorption is hindered as well. This causes a large amount of diluted urine.
Similar to central Diabetes insipidus, it can also be genetic.
But for acquired disorder, there are factors include: blockage in the urinary tract, High
calcium levels, low potassium levels and use of certain drugs such as lithium. So what are the symptoms of DI?
Both types of DI basically have the same symptoms. The most obvious one is polyuria, which is
excessive urination. About 3 liters to 15 liters of urine per day.
That’s really a lot because normal people only urinate about 1 Liter to 1.5 liter a
day. And due to the excessive loss of water, polydipsia
results (which is excessive thirst). And most of the time it is uncontrollable
and people need a large amount of water and even craving for ice water.
And if fluid intake is not enough, it will cause dehydration.
Symptoms due to dehydration include: dry skin, fatique and lethargy, headache, lower alertness,
Tachycardia (which is rapid heartbeat) and even possible coma. What are the treatments available to diabetes
insipidus? Since both types cannot be cured completely,
the treatment is most likely life-long. For central DI, which is due to lack or low
level of ADH, desmopressin can be given as nasal spray, tablets or injections.
Desmopressin is the synthesis form of ADH. It serves to control urine output, fluid balance
and prevent dehydration. and for mild cases for central DI, a prescription
for a certain amount of water intake can be given to ensure proper hydration.
On the other hand, for nephrogenic DI, which is due to the irresponsive of kidney to ADH,
a large amount of fluid intake is needed to prevent dehydration.
Diet of low-sodium, low-protein can be given to reduce urine output.
And finally medications such as nonsteroidal anti-imflammatory drugs and thiazide diuretics
can be given to relieve the symptoms. And that concludes all my presentation. Thank
you for listening.