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What Are The Similarities (if Any) Between Diabetes Insipidus And Diabetes Mellitus?

In What Ways Do Diabetes Insipidus & Diabetes Mellitus Differ?

In What Ways Do Diabetes Insipidus & Diabetes Mellitus Differ?

Diabetes insipidus and diabetes mellitus are very different conditions. The commonality between the two, besides the word "diabetes," is that both involve thirst and urination. Beyond this point the conditions differ significantly. The National Diabetes Information Clearinghouse defines three main types of diabetes mellitus and various other forms, all acting upon insulin levels that regulate blood sugar. Diabetes insipidus has four types and none of the forms relate to insulin production or regulation. Furthermore, the causes of the conditions, the hormones affected and condition management all differ between diabetes insipidus and mellitus. Video of the Day Diabetes insipidus is uncommon compared to diabetes mellitus in the general population. The cause of diabetes insipidus stems from an antidiuretic hormone, which is produced in the hypothalamus and stored in the pituitary gland at the base of the brain. MayoClinic.com indicates that the process of fluid excretion signaled by the hormone to the kidneys is disrupted either due to a defect in the kidney tubules or because of damage to the brain impacting the release of the antidiuretic hormone. The cause of diabetes mellitus is an insufficiency in a different hormone that is produced in the pancreas--either in the production of the hormone, or in the body's ability to respond to it. Diabetes mellitus is also referred to as sugar diabetes because the disease centers around the body's inability to properly process glucose, a form of sugar that is the body's primary energy source. Vasopressin is a hormone created and secreted by the brain for controlling water metabolism. According to the National Kidney and Urologic Diseases Information Clearinghouse, when this hormone is secreted to the kidneys it directs the kidneys t Continue reading >>

Diabetes Insipidus Vs Diabetes Mellitus Difference

Diabetes Insipidus Vs Diabetes Mellitus Difference

Diabetes insipidus is a disease characterized by excessive thirst with excretion of large amount diluted urine apr 7, 2016 diabetes (di) vs siadh syndrome inappropriate antidiuretic i addition,... Read More Read More Read More Your patient has Polyuria and polydipsia, so what is your differential diagnose? It could be Diabetes mellititus, diabetes insipidus, or psychogenic polydipsia. 1. Check patient's blood glucose... Read More DKA and HHS (HHNS) nursing NCLEX lecture review of the treatment, patient signs/symptoms, and management. Diabetic ketoacidosis and hyperosmolar hyperglycemia nonketotic syndrome are two complicati... Read More FULL VIDEO COVERS: Urine osmolarity and diabetes insipidus (central versus nephrogenic). Presented by USMLE Ace, Inc. For full video please visit www.usmleace.com Ace offers over 1800 questions,... Read More Continue reading >>

What Is The Difference Between Diabetes Mellitus And Diabetes Insipidus?

What Is The Difference Between Diabetes Mellitus And Diabetes Insipidus?

The word diabetes is an interesting one. Its origin is in the Greek language where it is derived from the word for a siphon or, more simply, a pipe or hose. This word was used to describe the disorder in ancient times because those suffering from it produced such plentiful amounts of urine that they were reminiscent of a water pipe. The reason for the plentiful amounts of urine lies in the fact that when the sugar glucose reaches excessively high levels in our bloodstream, it is filtered into the kidney and enters the urine in large quantities. Due to its chemical and physical properties, when large amounts of glucose are filtered by our kidneys into the urine, it cannot be fully reabsorbed and retains a large amount of water with it, thus creating very large volumes of urine. The second part of the name, mellitus, is derived from the word meaning sweet, as in mellifluous music. Mellitus was added when it was discovered that the urine in a person with diabetes and very high blood sugar is sweet. Diabetes insipidus is a disorder with an entirely different basis, but its sufferers share the siphon-like quality of very frequent and very high volume urination. Diabetes insipidus is due to failure of production or action of another vital hormone, known as arginine vasopressin (AVP), also called antidiuretic hormone (ADH), that is responsible for maintaining the normal volume and concentration of our urine. When AVP is deficient (usually due to damage or disease of the hypothalamus or pituitary gland) or fails to work (usually due to disease of or damage to the kidney), we are unable to concentrate our urine and it becomes excessively dilute. As such, it appears pale, almost colorless and watery—in a word insipid, hence insipidus. It is not sweet, as it has negligible amoun Continue reading >>

Neurogenic Diabetes Insipidus

Neurogenic Diabetes Insipidus

1. What are the causes of central diabetes insipidus? Central diabetes insipidus is a deficiency of antidiuretic hormone (ADH) secretion by the pars intermedia of the pituitary gland or a deficiency of ADH production by the hypothalamus. The reported causes of deficiency in dogs include neoplasia, trauma, and congenital abnormalities. 2. What clinical signs are caused by diabetes insipidus? The primary and only clinical signs of diabetes insipidus in most cases are polyuria and polydipsia (PU/PD), which typically are severe. Urinary incontinence is another common complaint and is the result of the marked polyuria induced by diabetes insipidus. Dogs with neoplasia or trauma may have clinical signs related to damage of surrounding structures in the brain. Progression of neurologic abnormalities often occurs in dogs with pituitary neoplasia. 3. How is a diagnosis of diabetes insipidus established? It is important to thoroughly evaluate a dog with suspected diabetes insipidus for other diseases that could cause PU/PD. Persistent isosthenuria or hyposthenuria confirms the presence of polyuria, while finding a urine specific gravity above 1.030 rules out persistent PU/PD. Hyposthenuria is most frequently found in dogs with central or nephrogenic diabetes insipidus, primary polydipsia, and hyperadrenocorticism. With the possible exception of evidence of dehydration, the complete blood count (CBC) and serum chemistry values of dogs with diabetes insipidus should be normal. A water deprivation test may be performed for confirmation of the diagnosis. 4. What is the protocol for performing a water deprivation test? For the results of a water deprivation test to be valid, causes of PU/PD other than central diabetes insipidus, nephrogenic diabetes insipidus, and primary (psychogenic Continue reading >>

Medterm Corner – Diabetes

Medterm Corner – Diabetes

Welcome back to Medical Terminology Corner! Let’s talk about a common disease that affects a lot of people and that is still not curable even though we have some very good and effective treatments for the disease – Diabetes. The name originated from old Greek: διαβαίνω: diabaino— cross, pass through, flow through). “Diabetes” is the general term for multiple diseases with one common symptom – copious urination or polyuria (definition of the prefix poly- is many or excessive and –uria: urine). Most of the time when people use term “diabetes” they talk about diabetes mellitus – a disease with high glucose levels in the blood. Ancient Greek physician Aretaeus from Cappadocia (30-90?A.D.) described excessive polyuria, that was related, in his opinion, to the abnormal water flow in the body. Another type of diabetes – diabetes insipidus, although extremely rare, was known since old ages but, until 18th century, people did not know the difference between diabetes mellitus and diabetes insipidus. So then, diabetes with the urine that was sweet to taste (imagine that doctors in old ages had to taste patient’s urine) was called – diabetes mellitus (from Latin mel — honey). In the 19th and the beginning of the 20th centuries, there was a significant scientific research done on diabetes insipidus that was related to the abnormality of the central nervous system and posterior (back) lobe of the hypophysis (pituitary gland) or neurohypophysis, when neurohypophysis does not secrete enough of the antidiuretic hormone (ADH) or vasopressin. In other type of diabetes insipidus there are normal levels of vasopressin, but impaired response to the hormone from kidneys. In clinical descriptions, the term “diabetes” most of the time means excessive thir Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

Practice Essentials Diabetes insipidus (DI) is defined as the passage of large volumes (>3 L/24 hr) of dilute urine (< 300 mOsm/kg). It has the following 2 major forms: Two other forms are gestational DI and primary polydipsia (dipsogenic DI); both are caused by deficiencies in AVP, but the deficiencies do not result from a defect in the neurohypophysis or kidneys. Signs and symptoms The predominant manifestations of DI are as follows: The most common form is central DI after trauma or surgery to the region of the pituitary and hypothalamus, which may exhibit 1 of the following 3 patterns: In infants with DI, the most apparent signs may be the following: In children, the following manifestations typically predominate: If the condition that caused DI also damaged the anterior pituitary or hypothalamic centers that produce releasing factors, patients may present with the following: Physical findings vary with the severity and chronicity of DI; they may be entirely normal or may include the following: See Clinical Presentation for more detail. If the clinical presentation suggests DI, laboratory tests must be performed to confirm the diagnosis, as follows: Additional studies that may be indicated include the following: See Workup for more detail. Management Most patients with DI can drink enough fluid to replace their urine losses. When oral intake is inadequate and hypernatremia is present, provide fluid replacement as follows: Give dextrose and water or an intravenous fluid that is hypo-osmolar with respect to the patient’s serum; do not administer sterile water without dextrose IV Administer fluids at a rate no greater than 500-750 mL/hr; aim at reducing serum sodium by approximately 0.5 mmol/L (0.5 mEq/L) every hour Pharmacologic therapeutic options include the follo Continue reading >>

Difference Between Diabetes Mellitus And Diabetes Insipidus

Difference Between Diabetes Mellitus And Diabetes Insipidus

Diabetes Mellitus vs Diabetes Insipidus Diabetes mellitus, which is commonly known as diabetes, is a condition in which the person suffering from it has high blood sugar. This may be because the body does not produce enough insulin or the cells do not respond to it. There are three different types of diabetes which are: Type 1, Type 2, and gestational diabetes. In Type 1 diabetes, the body does not produce enough insulin, and the person needs insulin injections. In Type 2 diabetes, the body does not respond to insulin and may also not produce enough of it. Gestational diabetes occurs only in pregnant women whereby a woman who never had diabetes before has a high blood glucose level during pregnancy. On the other hand, diabetes insipidus is a condition which is rare and causes frequent urination and excessive thirst. Like diabetes mellitus, it has different types and each has a different cause. The type which is more common is called central diabetes insipidus which is caused by a deficiency of the anti-diuretic hormone. This is due to damage of the pituitary gland and is treated by desmopressin which prevents water excretion. The second commonest type is nephrogenic diabetes insipidus which is caused by the kidneys being insensitive to the anti-diuretic hormone due to drugs or kidney disease. Diabetes mellitus is more common than diabetes insipidus. Both involve frequent urination and excessive thirst. Diabetes mellitus also results in vision changes due to prolonged high blood glucose which causes glucose absorption. People with this condition may also present with a sweet-smelling breath, vomiting, nausea, and abdominal pain. Diabetes insipidus is diagnosed by blood tests, urine tests, and a water deprivation test. Summary: 1.Diabetes mellitus is a condition in which Continue reading >>

Atorvastatin For The Treatment Of Lithium-induced Nephrogenic Diabetes Insipidus

Atorvastatin For The Treatment Of Lithium-induced Nephrogenic Diabetes Insipidus

Lithium remains the gold-standard treatment for bipolar disorder, with 30-40% of patients with responding preferentially to this medication. Additionally, lithium is commonly used in treatment-resistant depression, and other psychiatric disorders (e.g. schizoaffective disorder). Lithium is especially valuable considering the great difficulty in achieving and maintaining symptomatic remission, the high rates of disability, as well as tremendous personal, family, and societal costs associated with bipolar disorder and treatment-resistant depression. Despite this, clinicians are increasingly avoiding lithium, largely due to fear of irreversible chronic kidney disease (CKD), particularly in North America. It is well known that lithium exposure, even when dosed safely (<1.0mmol/L in adults 11 and <0.8mmol/L in geriatric patients 12,13), can increase the risk of CKD by 3 times, in large part through Nephrogenic Diabetes Insipidus (NDI) 14-19. NDI itself has also been associated with acute kidney injury 20, and life-threatening hypernatremia, which is an electrolyte imbalance characterized by high levels of blood sodium. Aside from hypertension, diabetes mellitus, aging, and other nonspecific CKD risk factors. NDI is characterized by excessive thirst (polydipsia) due to increased production of dilute urine (polyuria). In NDI, lithium is believed to interact with the inositol monophosphate and protein kinase C pathways, thereby affecting calcium-related intracellular signaling, cyclic AMP (cAMP), inhibition of Glycogen Synthase Kinase-3 Beta (GSK3Beta), activation of MAP Kinase and many other pathways. NDI occurs commonly in lithium users: 50% of chronic lithium users have urinary concentrating difficulties, with 12-19% have decreased urine osmolality (UOsm) <300mOsm/Kg). To da Continue reading >>

Diabetes Insipidus – Diagnosis And Management

Diabetes Insipidus – Diagnosis And Management

Abstract Central diabetes insipidus (CDI) is the end result of a number of conditions that affect the hypothalamic-neurohypophyseal system. The known causes include germinoma/craniopharyngioma, Langerhans cell histiocytosis (LCH), local inflammatory, autoimmune or vascular diseases, trauma resulting from surgery or an accident, sarcoidosis, metastases and midline cerebral and cranial malformations. In rare cases, the underlying cause can be genetic defects in vasopressin synthesis that are inherited as autosomal dominant, autosomal recessive or X-linked recessive traits. The diagnosis of the underlying condition is challenging and raises several concerns for patients and parents as it requires long-term follow-up. Proper etiological diagnosis can be achieved via a series of steps that start with clinical observations and then progress to more sophisticated tools. Specifically, MRI identification of pituitary hyperintensity in the posterior part of the sella, now considered a clear marker of neurohypophyseal functional integrity, together with the careful analysis of pituitary stalk shape and size, have provided the most striking findings contributing to the diagnosis and understanding of some forms of ‘idiopathic’ CDI. MRI STIR (short-inversion-time inversion recovery sequencing) is a promising technology for the early identification of LCH-dependent CDI. © 2012 S. Karger AG, Basel Definition/Classification Diabetes insipidus is a disease in which large volumes of dilute urine (polyuria) are excreted due to vasopressin (AVP) deficiency [central diabetes insipidus (CDI)], AVP resistance [nephrogenic diabetes insipidus (NDI)], or excessive water intake (primary polydipsia). Polyuria is characterized by a urine volume in excess of 2 l/m2/24 h or approximately 150 ml/k Continue reading >>

Diabetes Mellitus Vs. Diabetes Insipidus

Diabetes Mellitus Vs. Diabetes Insipidus

Many people assume that since both diabetes mellitus and diabetes insipidus begin with the word diabetes, they must be related. They also share two common warning signs: increased thirst and excessive urination. But the truth is that these conditions are not related at all. The latin word for diabetes means "to siphon." You could say that both conditions are due to some sort of siphoning or filtering problem—one is related to sugar and the other is related to fluid. That is where the similarities end. Below is a breakdown of what you need to know about diabetes mellitus and diabetes insipidus. Diabetes Mellitus In diabetes mellitus, your body is unable to regulate your blood’s glucose levels. When your body breaks down food into its most simple form, it is called glucose, which is a simple sugar that is carried in the blood to other cells in your body. Glucose is energy that your body needs for daily life. To supply your body with energy, glucose must be transferred out of the blood and into your other cells. A chemical called insulin is needed for this transfer. If there is a shortage of insulin to facilitate the process, then you will have a higher glucose level in your blood. Diabetes mellitus can be summed up in this way: not enough insulin and too much glucose. Types of Diabetes Mellitus Type 1 diabetes is most commonly diagnosed at a young age. It is the most common form of diabetes in persons younger than 20 years old. In this form of diabetes mellitus, the pancreas, the organ responsible for producing insulin, does not function properly. This causes hyperglycemia because of a shortage in insulin production. Therefore, type 1 diabetics must rely on insulin injections to survive. Type 2 diabetes is most commonly diagnosed in overweight, middle-aged adults. In Continue reading >>

Diabetes Insipidus (di) Vs Syndrome Of Inappropriate Antidiuretic Hormone (siadh)

Diabetes Insipidus (di) Vs Syndrome Of Inappropriate Antidiuretic Hormone (siadh)

Syndrome of inappropriate antidiuretic hormone (SIADH) and diabetes insipidus (DI) can confuse anyone because they are both endocrine disorders that involve the antidiuretic hormone (ADH). It is easy to assume that diabetes insipidus is part of the diabetes mellitus family, but it is not. However, this endocrine disorder is caused by the hyposecretion of ADH. On the other hand, SIADH is caused by the body releasing excess amount of ADH. Would you be able to look at a lab value of serum sodium and see if it is consistent with SIADH? Do you know the treatment priority for diabetes insipidus? To lose the confusion, Join David W. Woodruff, MSN, RN-BC, CNS, CEN who gave a clear insight on the comparison of diabetes insipidus and SIADH and a little pop quiz at the end of his presentation. If this video has helped you gain a better understanding of the two endocrine disorders, please share below! HT: www.ed4nurses.com Source: Silvestri, Linda Anne. “The Adult Client With an Endocrine Disorder.”Saunders Comprehensive Review for the NCLEX-RN Examination. 5th ed. St. Louis, MO: Saunders Elsevier, 2011. 652. Print. Continue reading >>

The Other Diabetes - Diabetes Insipidus

The Other Diabetes - Diabetes Insipidus

The more we know, the more we know we don't know. Now, doesn't that sound like we're talking about fibromyalgia? It seems there are new facets of the illness found every week (although that's probably a stretch). Yet, connections are made with other conditions and illnesses that may never have been connected before. A case in point would be the possible connection between fibromyalgia and diabetes insipidus. There's Another Diabetes? Most of us, when we hear the word diabetes, automatically attach mellitus to it. Diabetes mellitus is the condition in which blood sugars remain in a chronically high place. However, according to WebMD, diabetes is a general term for conditions that cause increased urine production. This is where diabetes insipidus beats all others because it results in excessive urination and extreme thirst. Diabetes insipidus puts those affected with it at increased risk for dehydration and it is caused by trouble with a hormone that is produced in the brain. Problems related to a specific hormone called antidiuretic hormone (ADH) or its receptor, are the cause of diabetes insipidus. ADH is produced by the hypothalamus and is stored by the pituitary gland in the brain. It is this hormone that causes the kidneys to hold onto water - hence the name "antidiuretic hormone". The urine, because it is held longer, is more concentrated when this hormone is doing its job properly. Under normal conditions, ADH levels rise in response to thirst or slight dehydration, which causes the kidneys to reabsorb more water and emit more concentrated urine. If an individual were to drink a gallon of water, then ADH levels would fall and the urine would be diluted and clear in color rather than dark and concentrated. When Things Aren't Working Right When ADH is problematic, ei Continue reading >>

Diabetes: The Differences Between Types 1 And 2

Diabetes: The Differences Between Types 1 And 2

Diabetes, or diabetes mellitus (DM), is a metabolic disorder in which the body cannot properly store and use sugar. It affects the body's ability to use glucose, a type of sugar found in the blood, as fuel. This happens because the body does not produce enough insulin, or the cells do not correctly respond to insulin to use glucose as energy. Insulin is a type of hormone produced by the pancreas to regulate how blood sugar becomes energy. An imbalance of insulin or resistance to insulin causes diabetes. Diabetes is linked to a higher risk of cardiovascular disease, kidney disease, vision loss, neurological conditions, and damage to blood vessels and organs. There is type 1, type 2, and gestational diabetes. They have different causes and risk factors, and different lines of treatment. This article will compare the similarities and differences of types 1 and 2 diabetes. Gestational diabetes occurs in pregnancy and typically resolves after childbirth. However, having gestational diabetes also increases the risk of developing type 2 diabetes after pregnancy, so patients are often screened for type 2 diabetes at a later date. According to the Centers for Disease Control and Prevention (CDC), 29.1 million people in the United States (U.S.) have diabetes. Type 2 diabetes is much more common than type 1. For every person with type 1 diabetes, 20 will have type 2. Type 2 can be hereditary, but excess weight, a lack of exercise and an unhealthy diet increase At least a third of people in the U.S. will develop type 2 diabetes in their lifetime. Both types can lead to heart attack, stroke, nerve damage, kidney damage, and possible amputation of limbs. Causes In type 1 diabetes, the immune system mistakenly attacks the insulin-producing pancreatic beta cells. These cells are destro Continue reading >>

Diabetes Insipidus: A Challenging Diagnosis With New Drug Therapies

Diabetes Insipidus: A Challenging Diagnosis With New Drug Therapies

ISRN Nephrology Volume 2013 (2013), Article ID 797620, 7 pages Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA Academic Editors: M. Léone and D. Malhotra Copyright © 2013 Chadi Saifan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Diabetes Insipidus (DI) is either due to deficient secretion of arginine vasopressin (central) or to tubular unresponsiveness (nephrogenic). Drug induced DI is a well-known entity with an extensive list of medications. Polyuria is generally defined as urine output exceeding 3 liters per day in adults. It is crucial to identify the cause of diabetes insipidus and to implement therapy as early as possible to prevent the electrolyte disturbances and the associated mortality and morbidity. It is very rare to have an idiosyncratic effect after a short use of a medication, and physicians should be aware of such a complication to avoid volume depletion. The diagnosis of diabetes insipidus is very challenging because it relies on laboratory values, urine output, and the physical examination of the patient. A high clinical suspicion of diabetes insipidus should be enough to initiate treatment. The complications related to DI are mostly related to the electrolyte imbalance that can affect the normal physiology of different organ systems. 1. Background Though it is a rare disorder, diabetes insipidus was first described in the 18th century [1]. Diabetes insipidus (DI) is either due to deficient secretion of arginine vasopressin (AVP), also known as antidiuretic hormone (ADH) by the pitu Continue reading >>

Family-oriented Support At The Onset Of Diabetes Mellitus: A Comparison Of Two Group Conditions During 2 Years Following Diagnosis

Family-oriented Support At The Onset Of Diabetes Mellitus: A Comparison Of Two Group Conditions During 2 Years Following Diagnosis

Abstract As part of a prospective, randomized study, the psychological effects of two different treatment regimens on the diagnosis of children and adolescents aged 3-15 years with insulin-dependent diabetes insipidus were evaluated. Conventional treatment was compared to a new regimen with a crisis programme which included a milieu therapeutic setting. A total of 38 families were randomly assigned to the 2 groups and followed over a period of 2 years after initial treatment. Parents' experiences of family climate and function over this period were registered and a test battery for the children was administered on five separate occasions. No decisive difference between the two groups was found. Few significant differences were found. Further investigation of the effects of the new treatment regimen on selected groups of families with defined extra needs is suggested. Continue reading >>

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