
Diabetes Insipidus
Recently, @EMHighAK (Alex Koyfman) asked about any “teaching points” with respect to Pediatric DKA and Cerebral Edema. In addition to referencing an oldie, but a goodie morsel on Cerebral Edema, I also mentioned that we should all be careful not to attribute all ketonuria in vomiting kids to “starvation ketosis.” That got me to thinking about other potential diabetes related urine pitfalls. What about the child with polyuria but no glucosuria? Is that reassuring and do I quickly assume that the child is just super-hydrated? Let us take a minute to recall that there is another diabetes to consider: Diabetes Insipidus.
“Diabetes,” etymologically, has origins in words that mean “to pass through” and was used to describe excessive passage of urine (polyuria).
“Mellitus” has origins from words that mean honey and/or sweetness.
“Insipidus” stems from words that meant lacking flavor or taste.
So to differentiate between the two, all we have to do is taste the urine. Simple.
This was how physicians of antiquity would evaluate the urine. (Delicious!)
Ok… I don’t advise this… and I’m pretty sure there are some hospital regulations that make that practice a reason to terminate your employment.
I am glad we have replaced human tongues with urine dipsticks for this!
Diabetes Insipidus = the inability to concentrate urine
Can be due to:
Central CNS process – vasopressin deficiency
Any process that impairs production and release of vasopressin can lead to diabetes insipidus. [Dabrowski, 2016]
Central Diabetes Insipidus (DI) is more common than Nephrogenic
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