Diabetes insipidus: causes and symptoms, treatment in women and men
Diabetes insipidus causes
Diabetes insipidus is a disease characterized by disorders in the urinary system and the hypothalamus. In most cases, the disease affects individual parts of the pituitary gland, which leads to improper production of the diuretic hormone vasopressin. The disease is often confused with diabetes mellitus, which is fundamentally wrong, since the pathologies differ from each other. The main differences between diseases are the reasons for their occurrence. In the case of diabetes insipidus, the following reasons are distinguished:
- neoplasms (tumors) in the brain;
- head trauma and damage;
- kidney disease, renal failure;
- toxic kidney damage;
- past operations on the brain;
- disturbed balance of calcium and potassium;
- congenital anomalies;
- hereditary predisposition.
The renal form of the disease develops against the background of ongoing pathological processes in the kidneys. Such disorders are associated with the excretory system or disruptions in hormonal processes. The central form is associated with disorders in the pituitary gland or hypothalamus. With this form, damage to the vascular system, tuberculosis, malaria or tumor processes occurs. Idiopathic diabetes is caused by the production of antibodies against hormone-forming cells.
Classification of diabetes insipidus
Diabetes insipidus is usually subdivided into types depending on the area in which the disorders that lead to the disease occur. There are three main types:
- Central (neurogenic). In this case, the synthesis of antidiuretic hormone is disrupted. With this type of kidney disease, the kidneys are unable to accumulate fluid, which causes a constant feeling of thirst and problems with urination. In cases where it is not possible to consume the required amount of liquid, dehydration develops, which leads to a coma.
- Idiopathic . During this form, there is no violation of the pituitary gland. The disease is inherited.
- Renal (nephrogenic) – disorders in the functioning of the kidneys.
Often the disease is inherited, so it is recommended that all family members undergo an examination for the presence of pathology.
To make a diagnosis, you need to know the symptoms of the disease. This largely depends on the specific form of diabetes insipidus. The first and most important symptom of pathology is frequent urination (polyuria) and an increased feeling of thirst (polydipsia). Symptoms of the disease:
- general malaise;
- weakness, tiredness;
- weight loss;
- violation of saliva secretion;
- rapid pulse;
- low pressure;
- an increase in the volume of the bladder;
- dry skin;
- disruptions in the work of enzymes of the gastrointestinal tract.
The state of health of patients worsens sharply. In addition to the main symptoms, the level of efficiency decreases, in some cases psychoemotional disruptions occur – a person becomes nervous and irritable, sleep is disturbed.
Diabetes insipidus in women
Diabetes insipidus is more common in women than in men. The disease is often confused with diabetes, but these are two different diseases. Diabetes insipidus is most often diagnosed in women under the age of 25 . The causes of the development of pathology are damage and trauma to the brain, as well as neoplasms. Sometimes the disease develops against the background of hormonal changes during pregnancy. This can, in the worst case, trigger a miscarriage. Signs of the disease in women:
- violation of the menstrual cycle;
- disruptions in blood pressure;
- increased urination;
- urinary incontinence (especially at night);
- unquenchable thirst.
Pathology is difficult for women after 30 years. Against the background of the disease, other disorders develop that affect the further ability to conceive and can lead to infertility.
Diabetes insipidus in men
In men, pathology is not so common, unlike in women. The main feature is frequent urination both at night and during the day. Increased thirst (more than 5 liters per day) is also cause for concern. Men over the age of 40 or in menopause are most susceptible to negative influence , which gives additional complications and leads to problems with potency. The symptomatology of the disease in men is similar to urological diseases, therefore, at the first sign, it is necessary to consult a doctor for diagnosis. Changes in the genital area, accompanied by an increased feeling of thirst or urination, signal the development of diabetes insipidus. Launched treatment can provoke other abnormalities in the reproductive system in men and lead to impotence and infertility. In adolescents and young men, diabetes insipidus causes sexual infantilism.
Diabetes insipidus in children
In children, the disease occurs from birth. However, full diagnosis and confirmation of the diagnosis is made when they reach 3 years of age. In childhood, the disease is difficult to diagnose, since it proceeds in completely different ways and has different symptoms. Signs of illness in children:
- rapid breathing (hyperpnea);
- increased excitability;
- decreased appetite;
- change in body temperature.
In rare cases, the disease can resolve in the absence of increased thirst. Sometimes the disease is completely asymptomatic. Therefore, pathology can only be detected with the help of special studies and analyzes. Diabetes insipidus can cause the development of psychosomatic or nervous disorders in children. In advanced cases, the disease leads to coma and death. Treatment is carried out through hormone replacement therapy.
Complications of the disease
The first effects of diabetes insipidus occur when the patient restricts fluid intake. At this time, dehydration of the body occurs, which leads to a decrease in body weight, an increase in temperature and frequent headaches. Patients suffer from dryness and peeling of the skin, distension of the bladder and stomach. If the condition is prolonged, then collapse or mental disturbances may occur . In children, the disease leads to an increase in body temperature, vomiting and enuresis. Complications and consequences in the form of diseases:
- cardiovascular pathologies – arrhythmia, tachycardia;
- nervous disorders – neuroses, insomnia, depression;
- problems in the genital area – violation of the menstrual cycle, decreased libido;
- pathological processes in the upper respiratory tract.
Ultimately, the disease can provoke a coma or be fatal. For full and timely treatment of diabetes insipidus, it is recommended to undergo a preventive examination by a doctor annually.
Diagnosis of diabetes insipidus
Various methods and techniques are used to diagnose diabetes insipidus. The reason for research is insatiable thirst and frequent urination. Research methods:
- urine test;
- biochemical analysis;
- Magnetic resonance imaging;
- CT scan;
- X-ray of the skull and Turkish saddle;
- Ultrasound of the kidneys;
- Zimnitsky test.
In addition to the indicated types of examination, it is recommended to additionally undergo an examination by an ophthalmologist, neuropathologist, neurosurgeon. Studies of urine and blood can determine the level of sodium and glucose, as well as determine its density. In addition, the content of potassium, calcium, urea and nitrogen is studied. Additionally, various tests are used to limit fluid intake. The procedure gives an idea of the nature of the origin (form) of diabetes insipidus. Differential diagnosis is also performed, which allows you to determine the type of disease between diabetes mellitus, insipidus and psychogenic polydipsia. The data obtained during the test are compared with the clinical indicators of each disease.
Diabetes insipidus treatment
Therapy of diabetes insipidus is prescribed only by the attending physician and depends on the nature of the origin of the disease. The neurogenic form of the disease involves the use of replacement therapy by taking or administering desmopressin (an analogue of vasopressin). The therapy is also aimed at eliminating pathological processes in the pituitary gland and hypothalamus. If tumors were found during the diagnosis, then the intervention of a surgeon is required. The renal form of the disease is difficult to treat, so diuretics are considered the most effective remedies to help reduce the load on the bladder. In case of a pathology that is of an inflammatory nature of origin, treatment with antibiotics or special desensitizing agents is prescribed. For autoimmune disorders, glucocorticosteroid drugs are used.
Diet for diabetes insipidus
Dieting for diabetes insipidus helps to significantly improve overall health and is aimed at eliminating frequent urination and enriching the body with useful vitamins and minerals. Various dried fruits, fresh fruits, vegetables, dairy products, as well as seafood and fish are suitable for this. To normalize digestion and work of the gastrointestinal tract, it is recommended to eat in small portions 5-6 times a day. Foods with protein content and high cholesterol content are excluded from the diet. Salt should also be avoided. It is recommended to steam, boil, bake or simmer food. It is forbidden to eat it fried. Foods that increase the feeling of thirst are also excluded. To quench it, it is best to use natural drinks: juices, compotes, fruit drinks. Drinking alcohol, smoking or other addictions is unacceptable.
Disability with diabetes insipidus
Diabetes insipidus is included in the international system of diseases included in endocrine disorders and has the ICD 10 code. Disability in the disease is associated with a decrease in the level of working capacity, polyuria (leaving the workplace in connection with this) and other factors. A disability group is assigned depending on the etiology of the disease, the degree of damage and the involvement of other organs in pathological processes. Thus, brain damage is considered a valid reason for assigning a disability group. Disability groups:
- 1 degree – there are no serious disorders of the endocrine system. Minor somatic disorders with minor signs of cerebral ischemia. Excretion of urine from 6 to 8 liters per day.
- Grade 2 (group 3) – optic nerve atrophy, hormonal disorders. The excreted level of urine per day is 8-14 liters.
- Grade 3 (group 2) – psychosomatic disorders with additional complications of internal organs and the central nervous system. The volume of urine excretion is more than 14 liters per day.
- 4 degree (group 1) – intracranial and arterial hypertension. Hormonal disorders, complete urinary incontinence. Genetic forms of the disease.
The assignment of a disability group occurs after all the necessary analyzes and research by a group of doctors. Efficiency is preserved in any type of diabetes insipidus, except for 4.
Diabetes insipidus responds well to treatment, which depends on the severity, etiology and form of the disease. Timely prescribed therapy allows you to cope with the disease and preserve vital activity. Cases of complete self-healing are extremely rare. Diabetes insipidus does not affect work capacity and does not reduce life expectancy. However, the disease is chronic. Compliance with the necessary rules and doctor’s recommendations will help reduce risks and improve quality of life.