Особенности диагностики и лечения несахарного диабета

Diabetes insipidus (diabetes, diabetes insipidus) – a pathology that disrupts the reabsorption of fluid in the renal tubules, making the urine unconcentrated. The disease occurs in both sexes and different age groups. More often the disease affects people from 18 to 25 years old and even children in the first year of life. It is registered in about 3 patients out of a hundred thousand. Diabetes insipidus is characterized by a violation of fluid resorption in the kidney structures, which leads to unnatural thirst and a large amount of urine. In some cases, a sick person consumes and excretes up to 20 liters of water. On estet-portal.com read about the clinical picture characteristic of this pathology, as well as methods for diagnosis and effective treatment of diabetes insipidus.

Classification and causes of onset of diabetes insipidus

Distinguish between diabetes insipidus central (hypothalamic, associated with insufficient synthesis or release of vasopressin into the blood) and renal (nephrogenic, when the kidneys do not absorb this hormone). Another known incipid syndrome or diabetes insipidus of nervous origin.


Sometimes, diabetes insipidus may appear in the third trimester of pregnancy, but disappear on its own after childbirth.


The causes of central diabetes include changes in the functioning of the hypothalamus and / or pituitary gland, malignant and benign brain tumors, impaired blood circulation or the structure of the vascular bed (aneurysm). There are cases when the symptoms of the disease appeared after:

  • transmitted viral infections;
  • injuries;
  • seasonal colds;
  • meningitis, encephalitis;
  • syphilis;
  • autoimmune pathologies.

Causes of nephrogenic diabetes insipidus include kidney disease, heredity, therapeutic course of certain medications, especially aminoglycoside antibacterial agents and medications with lithium.

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The gestational form of the disease occurs because placental enzymes break down the ADH (antidiuretic hormone) of the mother. Methods for diagnosing diabetes insipidus

The Robertson dry eating test will help diagnose diabetes insipidus. In the first 8 hours of the study, the patient is forbidden liquid in any form and food. If it is impossible to refuse food, then consume its minimum amount, choosing dry foods. Before the start of the test, determine:

blood osmolality;
  • blood pressure;
  • weight;
  • volume of urine excreted;
  • indicators of the general analysis of blood and urine.
    • The listed laboratory and instrumental diagnostic procedures are repeated after 1.5 – 2 hours. The test is stopped if the body weight of a sick person has decreased by 3 – 5%, his general condition noticeably worsened, the level of Na and blood osmolality increased.

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Telegram If urine with an osmolality of 650 mOsm/L is registered during the Robertson lean test, then the diagnosis of Diabetes Insipidus exclude.

Decrease in the relative density of urine (less than 1010 * in adults) and / or hypernatremia (more than 155 * mmol / l) also indirectly indicate an illness.

Additionally, a desmopressin test is done. If desmopressin administered (2 micrograms intravenously or subcutaneously) drastically reduces urine output, then

Diabetes Insipidus can be diagnosed. The leading symptoms of diabetes insipidus

There are two manifesting symptoms of the disease –

excessive thirst

causing you to drink large amounts of fluid (polydipsia) and frequent urination (polyuria). At the very beginning of the disease, a person drinks from 4 to 6 liters of water daily. As diabetes insipidus progresses, thirst increases and frequent nighttime visits to the toilet are debilitating, interfering with quality rest.

Further on, appetite worsens, up to its complete absence, which leads to weight loss. Unexplained irritability appears, efficiency decreases, the functions of the gastrointestinal tract are disturbed. The skin is dry, sweating is sharply reduced.

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Treatment of a severe complication diabetes mellitus – ketoacidosis Children noticeably lag behind in physical, sexual development. Women note a significant distortion in the regularity of the menstrual cycle, and men – decrease in potency up to impotence. If there is little fluid in the patient's body,

symptoms of dehydration come to the fore.  Basic principles for the treatment of diabetes insipidus

The therapeutic regimen is selected based on the form of the disease.

Central diabetes is treated with synthetic antidiuretic hormone analogues.

The nephrogenic form of diabetes insipidus requires a different type of therapy, therefore thiazide diuretics and non-steroidal anti-inflammatory drugs (NSAIDs) become the drugs of choice.

In pregnant women, expectant management is chosen, specific treatment is not carried out. If symptoms of dehydration appear, an antidiuretic hormone is prescribed.

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Specific immunotherapy for type I diabetes mellitus discovered Additionally, the treatment regimen includes vitamin, mineral complexes and general health-improving preparations. The patient is advised to normalize the regime of work and rest, spend more time outdoors, eat rationally, enriching the diet with fortified dishes, seasonal fruits and vegetables.

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