Analyzes for diabetes insipidus are complex diagnostic measures, including a general urinalysis, a biochemical blood test, a dry test, magnetic resonance therapy and other research methods.
Diabetes insipidus is a syndrome of the hypothalamic-pituitary system, belongs to a large group of pathologies of the endocrine glands. It is a mistake to consider this disease to be an analogue of type 1 or type 2 diabetes, since there is nothing in common between them, with the exception of a similar name.
Diabetes insipidus is a disease that is associated with an absolute or relative deficiency of the hormone vasopressin – the antidiuretic hormone. Absolute insufficiency is associated with a disorder in its production due to infectious ailments, tumor formations.
The relative lack of the hormone is based on the immunity of the renal tubule receptors to this hormone (this is due to a hereditary factor).
So, you should consider what causes contribute to the development of the disease, and what symptoms characterize it? Find out how the diagnosis of pathology is carried out, and what will human hemoglobin tell about?
Causes of the development of the disease
Why does this type of pathology arise, are patients interested? Part of the functionality of the hypothalamus is to regulate the production of two hormones: oxytocin and vasopressin, and the latter hormone promotes the reverse absorption of water by the kidneys.
After the hormones have developed, they are “sent” for temporary storage to the pituitary gland, and already from this part of the human body, as necessary, enter the circulatory system.
Deficiency of the antidiuretic hormone occurs against the background of fluid absorption in the kidneys, as a result of which the symptoms of the “classic sweet disease” are quite pronounced.
The second reason is the insensitivity of the soft tissues of the kidneys to the influence of the hormone presented. In medical practice, a group of factors is identified that can trigger the development of diabetes insipidus:
- Tumor masses in the brain affecting the pituitary and hypothalamus.
- Traumatic brain injuries.
- Complications after surgery on the brain.
- Genetic factor.
- Sexually transmitted disease – syphilis.
- A rare form of anemia.
- Metastases
- Pathology of the kidneys.
Practice shows that, despite a wide range of possible diagnostic measures in a particular case, only 70% of the clinical pictures can accurately determine the causes. In the remaining 30%, they remain unknown.
Clinical picture
During diabetes insipidus, the classic symptoms of a chronic disease develop. As a rule, the very first of them is a constant feeling of thirst, respectively, an increase in the specific gravity of urine per day. The patient absorbs much more water per day than he did before. Moreover, the flow of fluid does not alleviate the condition, I still want to drink.
Since the human body loses a lot of fluid, this immediately affects the condition of its skin. The skin becomes flaky, itching and other unpleasant symptoms join.
In some situations, there is a violation of the functioning of the digestive tract, which is manifested by nausea, bouts of vomiting.
Other symptoms may occur:
- Sweating is reduced.
- Emotional lability.
- Sleep disturbance.
- Blood pressure drops.
It should be noted that pathology affects the functionality of the human body as a whole, therefore, many representatives of the stronger sex have problems with potency, decreased libido.
Diabetes mellitus is divided into certain types. The first type is the renal form of the disease, the level of antidiuretic hormone is high, but the tissues of the kidneys cannot fully perceive it.
The central form of the disease develops due to a violation of the production of antidiuretic hormone at the cellular level of the hypothalamus.
Diabetes diabetes is also highlighted during gestation, which is considered a separate disease – diabetes of pregnant women. The disease passes immediately after the birth of the baby.
Diagnostic measures
The choice of certain diagnostic measures is based on the clinical picture of the patient, his complaints. For this, the doctor recommends a certain range of tests that help differentiate the ailment.
If there is a suspicion of developing any type of diabetes, the doctor recommends taking a blood test for sugar on an empty stomach. As a rule, two studies are always prescribed for reliability on different days.
When the glucose levels in the human body do not exceed the permissible limits, the development of diabetes mellitus (if there are similar symptoms) can be suspected. With diabetes insipidus, the glucose concentration does not increase.
Diagnostic measures and criteria for diabetes insipidus:
- Polyuria (at least three liters of urine per day).
- The norm of blood sugar by age (diabetes mellitus is excluded).
- Urine density is low (if the study showed a result of more than 1005, then this is not diabetes insipidus).
- Urine osmolarity (less than 300).
- There is no impaired renal function, high calcium, low potassium (the level of minerals is determined by a blood test).
- The analysis for hemoglobin. If there is an elevated level of hemoglobin, this speaks in favor of diabetes insipidus. With this type of pathology, hemoglobin in the blood, leukocytes, and red blood cells increase.
- Magnetic resonance therapy to exclude tumor formation in the brain.
The rate of hemoglobin depends on the gender of the patient. For women, the normal indicators are variability from 115 to 145, for representatives of the stronger sex it is considered to be the norm from 132 to 164.
Diagnostic measures include a dry test. The essence of the manipulation is to abstain from drinking fluid for 8-12 hours. If the patient has a diabetes insipidus, then body weight decreases by 5%, and an increase in urine density and osmolality is not observed.
Tests for diabetes insipidus imply a test according to Zemnitsky, which allows you to determine the water-releasing function of urine. For the study, 8-12 servings of urine are collected per day, the fence is carried out every few hours.
After that, each fence is examined for the amount of urine and its specific gravity.
Differential diagnosis
Along with research, differential diagnostic measures are mandatory, which make it possible to establish / refute a non-sugar disease by excluding certain pathologies.
Polydipsia of a psychogenic nature is based on the excessive use of large volumes of fluid, can develop with neurotic and mental disorders. In some situations, it arises due to impaired brain functionality.
Diuresis against the background of this pathological condition can contribute to an increase in the specific gravity of urine per day with a non-sugar form of diabetes. It is for this that a test is carried out when the patient refrains from taking fluid for some time.
The renal form of diabetes insipidus makes it possible to level the effectiveness of drugs based on antidiuretic hormone.
Differential diagnostic measures of the causes of diabetes insipidus in a patient are carried out. Initially, it is required to exclude the primary or metastatic tumor formation in the hypothalamus or pituitary gland.
The likelihood of developing a tumor in the pituitary gland increases in elderly patients.
Drug therapy
Based on the diagnosis, the results of laboratory tests and other tests, the doctor makes a conclusion. As noted above, there are certain criteria that can help diagnose diabetes insipidus.
If the patient has a low level of antidiuretic hormone, then treatment with drugs that include synthetic vasopressin is prescribed. All drugs of this plan are characterized by a prolonged effect, have a small list of adverse reactions.
Adiuretin is a medication that is buried in the sinuses, characterized by a long period of decay. Desmopressin is available in the form of tablets, has a small bioavailability. However, this is enough to create an antidiuretic effect.
Minirin tablets are often prescribed for treatment. Features of the use of the drug:
- The initial dosage is always small, not exceeding 100 mg per day.
- Based on the volume of urine per day, the dose is gradually increasing.
- You need to take half an hour before meals, or a few hours after it.
- The dose is always selected individually.
If the patient is diagnosed with diabetes insipidus of an inflammatory nature, then antibacterial therapy is prescribed. With the renal form of the disease, diuretics, anti-inflammatory drugs of a non-steroidal nature, sulfonylurea derivatives (diuretic