Tenzin Sangpo

A Case if Diabetes Insipidus

1. Describe the mechanism by which normal fluid regulation in the body occurs.
The kidney is the mechanism that regulates the volume of water in the plasma by
producing less urine to conserve water when the body is approaching dehydration and
remove extra water when the body is under hydration. The fluid intake is controlled by
the thirst mechanism and the fluid excretion is controlled by antidiuretic hormone
(ADH).
2. What is considered to be excessive thirst and urination in an adult?

Polyuria is considered when an adult urinates more than 50 ml/kg in body weight per 2
hours because this means they have a higher than normal output.
Polydipsia is considered when an adult consumes more than 12 glasses of any beverage
per day.

3. List and briefly describe the four types of diabetes insipidus.

- Central (Pituitary) Diabetes Insipidus: caused when damage occurs to the pituitary
gland or hypothalamus that leads to a defect in ADH
- Gestation Diabetes Insipidus: this occurs in pregnant women when caused by a
deficiency of the antidiuretic
- Dipsogenic Diabetes Insipidus: caused by a problem in the thirst mechanism because
of the malfunction excessive thirst occurs and suppresses ADH secretion and causes
an increase in the output of urine
- Nephrogenic Diabetes Insipidus: Caused when the kidneys are unable to respond to
ADH.

4. How is pituitary diabetes insipidus diagnosed?

Pituitary diabetes insipidus is diagnosed by checking the patient medical and family
history and a physical exam, followed by a few diagnostic test including urine test, blood
test, fluid deprivation test and MRI.

5. In what ways is diabetes insipidus similar to diabetes mellitus? In what ways do they
differ?

Diabetes insipidus and diabetes mellitus are similar because they both have the result in
the increasing effect of urination and thirst. They are different because they have different
causes and symptoms.

6. How does the mechanism why which diuresis occurs with diabetes insipidus differ from
that which occurs in diabetes mellitus?

Diabetes insipidus causes diuresis because of the different hormones changes that occur.
Diabetes mellitus causes diuresis because there is a high blood sugar concentration that
drains into the urine which takes along the excess water.
 Tenzin Sangpo

7. How does diabetes insipidus compare with a condition called syndrome of inappropriate
antidiuretic hormone (SIADH)?

It is the release of too much ADH from the pituitary gland or from their source. When
comparing, diabetes insipidus cannot produce the right amount of ADH and this is why
there is a production of too much urine. SIADH retains too much water and has to excrete
it into the DI.

8. What other conditions result in polyuria and polydipsia (PU/PD)?

Polyuria and polydipsia can be caused if a person should have a urine infection, adrenal
gland disease, thyroid disease, kidney disease, diabetes, or if a person is taking
medication, such as steroids.

9. What is DDAVP and how is it administered?

Desmopressin is used to control the symptoms of a certain type of diabetes insipidus.

vasopressin. Desmopressin is a form of ADH that is known as synthetic. It can be taken
as a nasal spray, nasal drops, injection, or oral tablet.

10. Why should a person who has pituitary diabetes insipidus and does not feel unreasonably
inconvenienced by the symptoms take treatment?

One who is not being treated or cannot replace the fluid loss might experience these
symptoms: severe dehydration, electrolyte imbalance, unconsciousness, heart attack or
even death can occur.

11. Why is ADH also known as vasopressin?

Vasopressin is known as an ADH because the arteries are able to be stimulated and they
are able to get the capillaries to contract.