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Thiazide Diuretic And Diabetes

Association Of Thiazidetype Diuretics With Glycemic Changes In Hypertensive Patients: A Systematic Review And Metaanalysis Of Randomized Controlled Clinical Trials

Association Of Thiazidetype Diuretics With Glycemic Changes In Hypertensive Patients: A Systematic Review And Metaanalysis Of Randomized Controlled Clinical Trials

Association of ThiazideType Diuretics With Glycemic Changes in Hypertensive Patients: A Systematic Review and MetaAnalysis of Randomized Controlled Clinical Trials Intensive Care Unit, Sun Yatsen University Cancer Center, Guangzhou, China Address for correspondence: Qingyu Zhao, MD, Sun Yatsen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, China Intensive Care Unit, Sun Yatsen University Cancer Center, Guangzhou, China Address for correspondence: Qingyu Zhao, MD, Sun Yatsen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, China Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Patients receiving thiazide diuretics have a higher risk of impaired glucose tolerance or even incident diabetes, but the change of blood glucose level varies across different trials. The aim of this study was to investigate the glycemic changes in hypertensive patients with thiazidetype diuretics. Twentysix randomized trials involving 16,162 participants were included. Thiazidetype diuretics were found to increase fasting plasma glucose (FPG) compared with nonthiazide agents or placebo or nontreatment (mean difference [MD], 0.27 mmol/L [4.86 mg/dL]; 95% confidence interval [CI], 0.150.39). Patients receiving lower doses of thiazides (hydrochlorothiazide or chlorthalidone 25 mg daily) had less change in FPG (MD, 0.15 mmol/L [2.7 mg/dL]; 95% CI, 0.030.27) than those receiving higher doses (MD, 0.60 mmol/L [10.8 mg/dL]; 95% CI, 0.390.82), revealed by the subgroup analysis of thiazides vs calcium channel blockers. Thiazide Continue reading >>

Thiazide Diuretics, Potassium, And The Development Of Diabetes

Thiazide Diuretics, Potassium, And The Development Of Diabetes

Thiazide Diuretics, Potassium, and the Development of Diabetes From the Purdue University College of Pharmacy (A.J.Z.), Department of Pharmacy Practice, West Lafayette, Ind; Department of Medicine (J.G.), Division of Nephrology, University of California-San Francisco; Division of Statistics (S.B.), Northern Illinois University, De Kalb; Preventive Medicine and Internal Medicine (G.L.B.), Hypertension/Clinical Research Center, Rush University Medical Center, Chicago, Ill; Division of Clinical and Administrative Pharmacy (B.L.C.), College of Pharmacy, Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City. From the Purdue University College of Pharmacy (A.J.Z.), Department of Pharmacy Practice, West Lafayette, Ind; Department of Medicine (J.G.), Division of Nephrology, University of California-San Francisco; Division of Statistics (S.B.), Northern Illinois University, De Kalb; Preventive Medicine and Internal Medicine (G.L.B.), Hypertension/Clinical Research Center, Rush University Medical Center, Chicago, Ill; Division of Clinical and Administrative Pharmacy (B.L.C.), College of Pharmacy, Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City. From the Purdue University College of Pharmacy (A.J.Z.), Department of Pharmacy Practice, West Lafayette, Ind; Department of Medicine (J.G.), Division of Nephrology, University of California-San Francisco; Division of Statistics (S.B.), Northern Illinois University, De Kalb; Preventive Medicine and Internal Medicine (G.L.B.), Hypertension/Clinical Research Center, Rush University Medical Center, Chicago, Ill; Division of Clinical and Administrative Pharmacy (B.L.C.), College of Pharmacy, Department of Family Medicine, Ro Continue reading >>

Drugs That Can Worsen Diabetes Control

Drugs That Can Worsen Diabetes Control

One of the main goals of any diabetes control regimen is keeping blood glucose levels in the near-normal range. The cornerstones of most plans to achieve that goal include following a healthy diet, getting regular exercise, and taking insulin or other medicines as necessary. However, it’s not uncommon for people with diabetes to have other medical conditions that also require taking medicines, and sometimes these drugs can interfere with efforts to control blood glucose. A few medicines, including some commonly prescribed to treat high blood pressure and heart disease, have even been implicated as the cause of some cases of diabetes. This article lists some of the medicines that can worsen blood glucose control, the reasons they have that effect, the usual magnitude of the blood glucose changes, as well as the pros and cons of using these drugs in people who have diabetes. Where the problems occur To understand how various medicines can worsen blood glucose control, it helps to understand how insulin, the hormone responsible for lowering blood glucose, works in the body. Insulin is released from the beta cells of the pancreas in response to rising levels of glucose in the bloodstream, rising levels of a hormone called GLP-1 (which is released from the intestines in response to glucose), and signals from the nerve connections to the pancreas. The secretion of insulin occurs in two phases: a rapid first phase and a delayed second phase. Both of these phases are dependent on levels of potassium and calcium in the pancreas. Insulin acts on three major organs: the liver, the muscles, and fat tissue. In the liver, insulin enhances the uptake of glucose and prevents the liver from forming new glucose, which it normally does to maintain fasting glucose levels. In muscle and f Continue reading >>

Diuretic-related Side Effects: Development And Treatment

Diuretic-related Side Effects: Development And Treatment

Please confirm that you would like to log out of Medscape.If you log out, you will be required to enter your username and password the next time you visit. Log out Cancel Diuretic-Related Side Effects: Development and Treatment Prolonged thiazide diuretic therapy can lead to glucose intolerance and may occasionally precipitate diabetes mellitus.[ 4 , 5 , 54 , 55 ] Short-term metabolic studies, epidemiologic studies, and a variety of clinical trials suggest a connection between ongoing thiazide diuretic use and the development of type 2 diabetes. However, it should be noted that interpretation of these studies is confounded by multiple factors including: differing definitions of new-onset diabetes, small numbers of patients, inadequate comparison groups, relatively limited periods of follow-up, selection criteria that limited the generalizability of the findings, and study designs that prohibited valid comparisons among antihypertensive drug classes.[ 56 ] Moreover, in a review of all the placebo-controlled hypertension trials with diuretics, there was only an approximate 1% increase in new-onset diabetes compared with placebo.[ 57 ] Hyperglycemia and carbohydrate intolerance have been linked to diuretic-induced hypokalemia. K+ deficiency is known to inhibit insulin secretion by cells; however, diuretic-induced changes in glucose metabolism are not conclusively related to altered K+ homeostasis, and impaired glucose tolerance occurs even when thiazide-type diuretics in relatively low doses are combined with K+ -sparing agents. The glucose intolerance seen with diuretic therapy can deteriorate further with an increase in sympathetic nervous system activity, which also decreases peripheral glucose utilization. Diuretic-associated glucose intolerance appears to be dose-rel Continue reading >>

Type 2 Diabetes And Thiazide Diuretics

Type 2 Diabetes And Thiazide Diuretics

Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors) In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes. These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents. Benefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabetic patients. Thiazides still play a key role in the management of patients with type 2 diabetes and hypertension. Cardiovascular diseaseDiureticHypertensionSGLT2 inhibitorThiazideType 2 diabetes This article is part of the Topical Collection on Other Forms of Diabetes and Its Complications This is a preview of subscription content, log in to check access No sources of funding were used to assist in the preparation of this manuscript. No conflicts of interest are directly relevant to the content of this manuscript. A.J. Scheen has received lecturer/scientific advisor/clinical investigator fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck Sharp & Dohme, NovoNordisk, Sanofi, and Servier. Human and Animal Rights and Informed Consent This article does not contain any stud Continue reading >>

Type 2 Diabetes And Thiazide Diuretics.

Type 2 Diabetes And Thiazide Diuretics.

Curr Diab Rep. 2018 Feb 5;18(2):6. doi: 10.1007/s11892-018-0976-6. Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Lige, University of Lige, CHU Sart Tilman (B35), B-4000, Liege, Belgium. [email protected] Clinical Pharmacology Unit, CHU Lige, Center for Interdisciplinary Research on Medicines (CIRM), University of Lige, Lige, Belgium. [email protected] In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes. These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents. Benefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabetic patients. Thiazides still play a key role in the management of patients with type 2 diabetes and hypertension. Cardiovascular disease; Diuretic; Hypertension; SGLT2 inhibitor; Thiazide; Type 2 diabetes Continue reading >>

Lower Blood Pressure, Higher Glucose?

Lower Blood Pressure, Higher Glucose?

I've read that hydrochlorothiazide can raise blood sugar levels. Is this true? My doctor prescribed it for my high blood pressure, but why would he do that if he knew it could raise my glucose levels? — Connie, Ohio The jury is still out regarding the long-term effect of hydrochlorothiazide on blood glucose because the results from studies have been mixed. While some studies have shown that there is indeed a higher risk of elevated glucose, others have not confirmed this finding. Here's what we know: Individuals who are taking thiazide diuretics, of which hydrochlorothiazide is one, can develop a mild case of elevated glucose, usually if their potassium levels are also low. When the potassium level normalizes, the glucose level goes back to normal. Thiazide diuretics have proven beneficial to people with high blood pressure and are among the best, safest, and least expensive of blood pressure drugs. The use of beta-blockers (which are also prescribed to treat high blood pressure) along with thiazide diuretics can, however, increase blood glucose levels. It is possible that hydrochlorothiazide increases the production of glucose from the liver, and because beta-blockers limit the absorption of glucose into cells, the use of these medicines in tandem can raise glucose levels significantly enough to cause diabetes. My recommendation is this: Make sure your potassium level is normal or high-normal when taking hydrochlorothiazide. If your doctor tells you that your levels are low, eating bananas — which are rich in potassium — can help. And, unless absolutely necessary, avoid mixing beta-blockers with hydrochlorothiazide. Your best bet is to visit your doctor. Ask him to explain the benefits and risks of taking hydrocholorthiazide versus some other antihypertensive dru Continue reading >>

Thiazide Diuretic Prophylaxis For Kidney Stones And The Risk Of Diabetes Mellitus - Sciencedirect

Thiazide Diuretic Prophylaxis For Kidney Stones And The Risk Of Diabetes Mellitus - Sciencedirect

Volume 192, Issue 6 , December 2014, Pages 1700-1704 Thiazide Diuretic Prophylaxis for Kidney Stones and the Risk of Diabetes Mellitus Get rights and content Thiazide diuretics used to treat hypertension are associated with a modest risk of diabetes mellitus. It is unknown if there is a similar risk with kidney stone prevention. We identified and validated incident stone formers in Olmsted County, Minnesota from 1984 to 2011 with manual review of medical records using the Rochester Epidemiology Project. The risk of diabetes mellitus after thiazide therapy was evaluated with and without multivariate adjustment for hypertension, age, gender, race, family history of stones, body mass index and number of stone events. Among 2,350 incident stone formers with a median followup of 10 years, 332 (14%) were treated with thiazide diuretics at some point after the first stone event and 84 (3.6%) received the thiazide diuretic only for kidney stone prevention. Stone formers who received thiazide diuretics were more likely to be older, have hypertension, have higher body mass index and have more stone events. The incidence of diabetes mellitus at 10 years after the first stone event was 9.2% in the group that received thiazide diuretics vs 4.2% in those who did not (HR 2.91; 95% CI 2.02, 4.20). After multivariate adjustment the risk of diabetes mellitus was attenuated (HR 1.20; 95% CI 0.78, 1.83). The risk of diabetes mellitus among those receiving thiazide diuretics solely for kidney stones was further attenuated (multivariate adjusted HR 0.80; 95% CI 0.28, 2.23). Thiazide diuretic use for kidney stone prophylaxis was not associated with a high risk of diabetes mellitus. Larger studies are needed to determine if there is a modest risk of diabetes mellitus with thiazide diuretics. Continue reading >>

Should We Prescribe Diuretics For Patients With Prediabetes And Hypertension?

Should We Prescribe Diuretics For Patients With Prediabetes And Hypertension?

Should we prescribe diuretics for patients with prediabetes and hypertension? Should we prescribe diuretics for patients with prediabetes and hypertension? BMJ 2008; 337 doi: (Published 21 August 2008) Cite this as: BMJ 2008;337:a679 1Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland, New Zealand 1142 Correspondence to: B Arroll b.arroll{at}auckland.ac.nz The uncertainty arises from the findings of the large randomised controlled ALLHAT 2002 trial (31 512 people 55 years or older with hypertension and one other risk factor for cardiovascular disease), in which the thiazide-like diuretic chlortalidone seemed to increase some cardiac risk factors, including the rate of developing diabetes. After four years of follow-up in those who had a normal fasting blood glucose at baseline, 302 (11.6%) people taking chlortalidone, 154 (9.8%) of those taking amlodipine (a calcium channel blocker), and 119 (8.1%) of those taking lisinopril (an angiotensin converting enzyme inhibitor) had fasting blood glucose concentrations of 7 mmol/l (P<0.001).1 Diuretics are known to achieve long term cardiovascular results as good as, or better than, alternative antihypertensivesat least in people aged 55 years or older. But clinicians may not initially treat patients with prediabetes and hypertension with a diuretic because they worry that the induced diabetes might result in a worse outcome than if they prescribed a different class of antihypertensive. International guidelines give conflicting advice, presumably because of this uncertainty. The National Institute for Health and Clinical Excellence (NICE) advises general practitioners in the United Kingdom to use diuretics and calcium channel blockers as first line treatments in patients o Continue reading >>

Prime Pubmed | Type 2 Diabetes And Thiazide Diuretic

Prime Pubmed | Type 2 Diabetes And Thiazide Diuretic

Scheen AJ: "Type 2 Diabetes and Thiazide Diuretics." Current diabetes reports, vol. 18, no. 2, 2018, p. 6, Accessed October 27, 2018. Scheen AJ. Type 2 Diabetes and Thiazide Diuretics. Curr Diab Rep 2018;18(2):6 Accessed October 27, 2018. Scheen AJ. (2018). Type 2 Diabetes and Thiazide Diuretics. Current diabetes reports, 18, p. 6. doi:10.1007/s11892-018-0976-6 Scheen AJ. Type 2 Diabetes and Thiazide Diuretics. Curr Diab Rep. 2018;Feb0518:6 TY - JOURT1 - Type 2 Diabetes and Thiazide Diuretics.A1 - Scheen,Andr J,Y1 - 2018/02/05/PY - 2018/2/6/entrezPY - 2018/2/6/pubmedPY - 2018/2/6/medlineKW - Cardiovascular diseaseKW - DiureticKW - HypertensionKW - SGLT2 inhibitorKW - ThiazideKW - Type 2 diabetesSP - 6EP - 6JF - Current diabetes reportsJO - Curr. Diab. Rep.VL - 18IS - 2N2 - PURPOSE OF REVIEW: In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes. RECENT FINDINGS: These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents. Benefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabetic patients. Thiazides still play a key role in the management of Continue reading >>

Treatment Of Hypertension In Patients With Diabetes Mellitus

Treatment Of Hypertension In Patients With Diabetes Mellitus

INTRODUCTION AND PREVALENCE Hypertension is a common problem in patients with both type 1 and type 2 diabetes, but the time course in relation to the duration of diabetes is different [1-3]. Among those with type 1 diabetes, the incidence of hypertension rises from 5 percent at 10 years, to 33 percent at 20 years, and 70 percent at 40 years [1]. There is a close relation between the prevalence of hypertension and increasing albuminuria. The blood pressure typically begins to rise within the normal range at or within a few years after the onset of moderately increased albuminuria (the new term for what was previously called "microalbuminuria") [2] and increases progressively as the renal disease progresses. (See "Moderately increased albuminuria (microalbuminuria) in type 1 diabetes mellitus", section on 'Risk factors'.) These features were illustrated in a study of 981 patients who had type 1 diabetes for five or more years [3]. Hypertension was present in 19 percent of patients with normoalbuminuria, 30 percent with moderately increased albuminuria, and 65 percent with severely increased albuminuria (the new term for what was previously called "macroalbuminuria") [2]. The incidence of hypertension eventually reaches 75 to 85 percent in patients with progressive diabetic nephropathy [4]. The risk of hypertension is highest in blacks, who are also at much greater risk for renal failure due to diabetic nephropathy. (See "Overview of diabetic nephropathy".) The findings are different in patients with type 2 diabetes. In a series of over 3500 newly diagnosed patients, 39 percent were already hypertensive [5]. In approximately one-half of these patients, the elevation in blood pressure occurred before the onset of moderately increased albuminuria. Hypertension was strongly a Continue reading >>

Controlling Hypertension In Patients With Diabetes

Controlling Hypertension In Patients With Diabetes

Hypertension and diabetes mellitus are common diseases in the United States. Patients with diabetes have a much higher rate of hypertension than would be expected in the general population. Regardless of the antihypertensive agent used, a reduction in blood pressure helps to prevent diabetic complications. Barring contraindications, angiotensin-converting enzyme inhibitors are considered first-line therapy in patients with diabetes and hypertension because of their well-established renal protective effects. Calcium channel blockers, low-dose diuretics, beta blockers, and alpha blockers have also been studied in this group. Most diabetic patients with hypertension require combination therapy to achieve optimal blood pressure goals. Nearly one in four adults in the United States has hypertension, and more than 10 million adults have diabetes.1 Moreover, hypertension is twice as common in persons with diabetes as it is in others.2 Obesity may be a common link between the two disorders, but other factors such as insulin resistance3 and autonomic dysfunction4 may also be involved. Excess weight with truncal obesity, hypertension, impaired glucose tolerance, insulin resistance, and dyslipidemia are among the components of the metabolic syndrome, which has been associated with an increased risk of coronary heart disease.5 In general, only 25 percent of patients with hypertension have adequate control of their blood pressure.6 Blood pressure goals are lower, and thus more difficult to achieve, in patients who also have diabetes. Elevated blood pressure is known to contribute to diabetic microvascular and macrovascular complications (Table 1).4,7,8 Fortunately, reductions in blood pressure can decrease the risk of these complications.8 TABLE 1 Microvascular complications Renal d Continue reading >>

Is Diuretic-induced Hyperglycemia Reversible And Inconsequential?

Is Diuretic-induced Hyperglycemia Reversible And Inconsequential?

Short report *Corresponding author: Anil K Mandal [email protected] 1. Mandal Diabetes Research Foundation, St. Augustine, Florida and University of Florida, Gainesville,Florida, USA. © 2012 Mandal et al; licensee Herbert Publications Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Antihypertensive drugs including thiazide diuretics, beta blockers (BB), calcium channel blockers (CCB), reninangiotensin inhibitors or vasodilators produce elevated blood glucose (hyperglycemia) (>70-99 mg/dL). Hyperglycemia is more common and severe with thiazide diuretics than with BB, CCB, ACEI or ARB drugs. Questions have been raised about the mechanism and risk of drug-induced hyperglycemia. Method: We present here four patients treated with diuretics who developed hyperglycemia - fasting blood glucose (FBG) > 126 mg/ dL (7 mmol/L) diagnostic of diabetes. Three patients had hypertension and one, congestive heart failure (CHF). Three patients had no diabetes, one gave 8 to 10 year history of diabetes. One patient received no diuretic therapy and his glucose level was normal with insulin and oral hypoglycemic agent treatment. Subsequently, he became hypertensive and was treated with a thiazide diuretic but no antidiabetic agents. He then developed new-onset diabetes. Results: All patients showed hyperglycemia above FBG criteria for diabetes. 2-hour postprandial blood glucose (2hPPG) was not diagnostic of diabetes in three patients. Two patients were prescribed antidiabetic therapy which was stopped with no worsening of hyperglycemia although diuretic therapy continued. In two patien Continue reading >>

Diuretics May Increase Diabetes Risk By Lowering Blood Potassium Levels

Diuretics May Increase Diabetes Risk By Lowering Blood Potassium Levels

Diuretics may increase diabetes risk by lowering blood potassium levels Posted on Nov 25, 2008, 6 a.m. By Rich Hurd New research suggests that depleted blood potassium levels could help to explain why people prescribed diuretics for the treatment of high blood pressure are at increased risk of type 2 diabetes. New research suggests that depleted blood potassium levels could help to explain why people prescribed diuretics for the treatment of high blood pressure are at increased risk of type 2 diabetes. Tariq Shafi and colleagues examined data from 3,790 non-diabetic participants in the Systolic Hypertension in Elderly Program (SHEP), a study designed to determine the risk versus benefit of treating people age 60 years or older with the thiazide diuretic chlorthalidone. Previous research has shown that treatment with thiazide diuretics causes potassium levels to drop and increases patients' risk of developing type 2 diabetes by as much as 50%, although whether the drop in blood potassium was linked to the increased risk of diabetes was uncertain. Results of this study suggest that the increased risk of type 2 diabetes associated with thiazide diuretics is indeed linked to their action on blood potassium levels. In fact, results showed that for each 0.5 milliequivalent-per-liter (MEq/L) decrease in serum potassium, there was a 45% increased risk of diabetes . Thiazides are effective at treating high blood pressure and are inexpensive, however their association with diabetes has led many doctors to prescribe other, more expensive, drugs. However, according to Dr Shafi, the study findings suggest that thiazides can be used safely as long as doctors monitor and regulate blood potassium levels. The authors speculate that potassium supplement may prevent thiazide-induced diab Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst.[1] The amount of urine produced can be nearly 20 liters per day.[1] Reduction of fluid has little effect on the concentration of the urine.[1] Complications may include dehydration or seizures.[1] There are four types of DI, each with a different set of causes.[1] Central DI (CDI) is due to a lack of the hormone vasopressin (antidiuretic hormone).[1] This can be due to damage to the hypothalamus or pituitary gland or genetics.[1] Nephrogenic diabetes insipidus (NDI) occurs when the kidneys do not respond properly to vasopressin.[1] Dipsogenic DI is due to abnormal thirst mechanisms in the hypothalamus while gestational DI occurs only during pregnancy.[1] Diagnosis is often based on urine tests, blood tests, and the fluid deprivation test.[1] Diabetes mellitus is a separate condition with an unrelated mechanism, though both can result in the production of large amounts of urine.[1] Treatment involves drinking sufficient fluids to prevent dehydration.[1] Other treatments depend on the type.[1] In central and gestational disease treated is with desmopressin.[1] Nephrogenic disease may be treated by addressing the underlying cause or the use of a thiazide, aspirin, or ibuprofen.[1] The number of new cases of diabetes insipidus each year is 3 in 100,000.[4] Central DI usually starts between the ages of 10 and 20 and occurs in males and females equally.[2] Nephrogenic DI can begin at any age.[3] The term "diabetes" is derived from the Greek word meaning siphon.[5] Signs and symptoms[edit] Excessive urination and extreme thirst and increased fluid intake (especially for cold water and sometimes ice or ice water) are typical for DI.[6] The symptoms of excessive urination Continue reading >>

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