Diabetes insipidus, unlike diabetes mellitus, is rarely diagnosed. Its causes are hidden in other mechanisms than in diabetes mellitus, although both diseases relate to the endocrine system of the body.
Description of the disease
Diabetes insipidus is a consequence of pathological changes in the pituitary gland. The latter arise from benign or malignant neoplasms. Other causes of the development of the disease are neurosurgical interventions that affect the work of the pituitary gland. These pathologies lead to a lack of the hormone vasopressin, which is also called antidiuretic hormone.
Twenty percent of patients after neurosurgical intervention developed diabetes insipidus. This disease is not genetically transmitted, but the clinical picture indicates if the relatives had endocrinological diseases and diabetes insipidus, in particular.
Patients with diabetes insipidus account for only one percent of the total number of patients with hormonal abnormalities. The incidence is the same in both sexes, sometimes congenital, but late diagnosed disease.
Symptoms
Symptoms and treatment of diabetes insipidus in women are established by the attending endocrinologist. The main symptoms of diabetes insipidus are excruciating thirst and frequent urination.
Polyuria, or increased urge to empty the bladder, is also characterized by an increase in urine volume. Most often, the volume increases to ten liters of urine per day, in severe cases, the volume can increase to thirty liters.
The urine is transparent, insignificant salt sediments and suspended particles are distinguishable in it. In addition, intense thirst and the volume of water consumed can reach the daily urine volume.
Symptoms of diabetes insipidus in women are also manifested in dry skin, significant salivation, sweating, but decreased appetite. After that, headaches, low blood pressure and significant weight loss appear. Vomiting and diarrhea may develop.
The main signs of diabetes insipidus in female patients:
- Intense thirst;
- Frequent urination;
- Dry skin;
- Headache;
- Nausea;
- Diarrhea;
- Losing weight for no apparent reason;
- Descent of the stomach due to the large volume of water passed through.
It should be noted that headaches and nausea are signs of later diabetes insipidus, which develop in the subsequent stages after the initial stage.
Symptoms during pregnancy
Sometimes signs of diabetes insipidus are found in women during pregnancy. This is due to the fact that bearing a child provokes serious hormonal changes that cannot but affect the production of vasopressin. Considering the fact that the pituitary gland is responsible for several hormones that a woman needs for normal gestation, the signs of diabetes appear due to the increased activity of the pituitary gland during this period.
Before pregnancy, the disease may be asymptomatic. During gestation, too frequent urge to urinate begins, which are mistakenly diagnosed by doctors, as the pressure of the growing uterus and fetus on the bladder. The symptom is joined by neurosis, insomnia or prolonged falling asleep, neuralgic diseases, emotional instability.
In a child, such a disease can manifest itself as enuresis, which is dangerous with late development and delayed puberty. If such symptoms are found, it is better to get diagnosed immediately, despite the fact that the symptoms are similar to the normal manifestations of pregnancy.
Central diabetes
The development of central diabetes insipidus in women may occur because the kidneys do not have the ability to store fluids. As a result, the patient suffers from two problems at once: intense thirst and frequent urination.
If the patient has the opportunity to consume unlimited quantities of clean water, this does not pose any danger to life. If water consumption is limited, and thirst is not quenched in time, dehydration may develop, which in a severe stage develops into a coma.
Chronic diabetes insipidus can lead to a decrease in sensitivity to antidiuretics, which are prescribed to patients as replacement therapy.
At the same time, a large amount of fluid intake can lead to problems with the biliary tract and gastric emptying.
Idiopathic diabetes
It is the third most common diabetes insipidus. When diagnosing a disease, no pathologies and organic changes in the pituitary gland are usually detected, meanwhile, the hormonal system and substances that depend on the work of the pituitary gland are produced in insufficient quantities. This form of the disease is hereditary.
Renal diabetes
The disease can be triggered by pathologies of renal function, as well as disturbances in the work of the enzymatic system. This is a rather rare form. If such a diagnosis is made to children, the form is considered congenital. It develops due to a mutation in the aquaporin gene or pathology of the vasopressin receptor.
In adults, the development of acquired renal diabetes insipidus is possible, then the causes are renal failure or prolonged use of drugs containing lithium.
Possible complications
Among the dangerous complications of diabetes insipidus is dehydration. Clinically, this diagnosis sounds like dehydration of the body. When the fluid lost in the urine in the body is not replenished, dehydration syndrome develops.
He is characterized by weakness, mental disorders, consisting in poor perception of the environment, loss of time, memory loss. Tachycardia develops, diarrhea and vomiting are possible.
Following this, blood begins to thicken, neuralgic disorders, hypotension develop. Without relieving this condition, dehydration can lead to collapse.
An interesting and remarkable fact is that even with severe dehydration syndrome, the ability to urinate in the same volumes and quantities as before is retained.
Diagnostic methods
Diagnosis of the disease in women is carried out by an endocrinologist. The first test that needs to be done is a polyuria test.
A healthy body in a normal state secretes no more than three liters of urine per day. In patients with diabetes insipidus, this indicator is at least twice as high. In addition, urine analysis reveals its low density and low specific gravity.
Another test requires the patient to abstain from fluids for eight hours. If, at the same time, a sharp decrease in weight is detected, and the density of urine decreases, the diagnosis can be confirmed.
To exclude other diseases with similar symptoms, the following examinations are prescribed:
- Blood test for C-peptide and glucose to exclude diabetes mellitus
- MRI of the brain to exclude tumors in the pituitary gland
- Examination by a neurologist to detect possible complications from the central nervous system
- Ultrasound of the kidneys and urinalysis to examine the condition of the kidneys, ureters and bladder.
It is required to complete all stages of the examination as early as possible in order to prevent complications, gastric emptying, irritable bowel syndrome and dehydration. In addition, an abundance of water in the intestines can lead to leaching of natural microflora and dysbiosis with indigestion. Therefore, passing diagnostics is a must.
Treatment methods
Treatment of diabetes insipidus is divided into general, applicable to all types of diabetes, as well as individual for each type.
- With symptomatic diabetes, that is, one that is a complication of other diseases, they try to first exclude the root cause. For example, with organic lesions of the pituitary gland or tumors.
- In any form of the disease, substitution therapy is prescribed. Since the antidiuretic hormone is not fully produced, a synthetic analogue is prescribed for administration. It is taken orally or dripped onto the nasal mucosa.
- Replacement therapy is not immediately used to treat central diabetes. Here they try to activate the secretion of antidiuretic hormone produced by the body, therefore, appropriate drugs are prescribed to stimulate the production of the hormone.
- The patient also needs to replenish the water-salt balance. For this, saline solutions are injected in large volumes. Combination of saline solutions and diuretics, water is retained in the body, and the number and volume of urination decreases.
Nutrition
The patient's diet should exclude the frequent use of proteins. Peptides place significant stress on already stressed kidneys. In addition, the percentage of fat and carbohydrates in the patient's diet increases.
Food is taken fractionally and often, increasing the consumption of vegetables and fruits as sources of natural fiber.
With a strong thirst, it is recommended to drink not only clean water without gas and dyes, but compotes, juices, homemade fruit drinks. You can replace protein products with soy products, as well as cook dishes by boiling, stewing and steaming, rarely getting carried away with fried foods.
Conclusion
With timely detection, especially during pregnancy, diabetes insipidus does not threaten a person with anything dangerous. Proper treatment, nutrition and maintenance of kidney function will give the patient a calm and healthy life. If the symptoms of diabetes are neglected, its developing stages can lead to dehydration, coma and death.
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