Diabetic polyuria

For diabetic polyuria, add Radix Dioscoreae Oppositae (Shan Yao) and Fructus Corni Officinalis (Shan Zhu... 

The symptoms that are manifested with DKA result from dehydration secondary to the hyperosmotic state and the resulting fluid and electrolyte imbalance, as well as secondary to the acidosis resulting from use of adipose tissue for energy and the buildup of ketones in the blood. The classic signs of diabetes— polyuria, polydipsia, and polyphagia—are also present. 

In nephrogenic diabetes insipidus the kidney s ability to respond to AVP is impaired by different causes, such as drugs (e.g. lithium), chronic disorders (e.g. sickle cell disease, kidney failure) or inherited genetic disorders (X-linked or autosomal NDI). This type of diabetes insipidus can not be treated by exogenous administration of AVP or AVP analogues. Instead, diuretics (hydrochlorothiazide combined or not with amiloride) and NSAI (indomethacin) are administrated to ameliorate polyuria. 

Those with type 1 diabetes mellitus produce insulin in insufficient amounts and tiierefore must have insulin supplementation to survive Type 1 diabetes usually has a rapid onset, occurs before die age of 20 years, produces more severe symptoms tiian type 2 diabetes, and is more difficult to control. Major symptoms of type 1 diabetes include hyperglycemia, polydipsia (increased thirst), polyphagia (increased appetite), polyuria (increased urination), and weight loss. Treatment of type 1 diabetes is particularly difficult to control because of the lack of insulin production by die pancreas. Treatment requires a strict regimen tiiat typically includes a carefully calculated diet, planned physical activity, home glucose testing several times a day, and multiple daily insulin injections. 

Symptoms of diabetes plus a casual plasma glucose concentration greater than or equal to 200 mg/dL (11.1 mmol/L). Casual is defined as any time of day without regard to time since last meal. The classic symptoms of diabetes include polyuria, polydipsia, and unexplained weight loss. 

Diabetes insipidus (polyuria due to decreased antidiuretic hormone)... 

Diabetes insipidus Polyuria due to the failure of renal tubules to reabsorb water in response to antidiuretic hormone. 

The answer is c. (Katzung, p 493.) Lithium treatment frequently causes polyuria and polydipsia. The collecting tubule of the kidney loses the capacity to conserve water via anti diuretic hormone. This results in significant free-water clearance, which is referred to as nephrogenic diabetes insipidus. 

Between 20% and 40% of patients present with diabetic ketoacidosis after several days of polyuria, polydipsia, polyphagia, and weight loss. 

Casual is defined as any time of day without regard to time since last meal. The classic symptoms of diabetes indude polyuria,... 

Lithium reduces the kidney s ability to concentrate urine and may cause a nephrogenic diabetes insipidus with low urine specific gravity and low osmolality polyuria (urine volume greater than 3 L/day). This may be treated with loop diuretics, thiazide diuretics, or triamterene. If a thiazide diuretic is used, lithium doses should be decreased by 50% and lithium and potassium levels monitored. 

Willis (1621-1675) appreciated that the sweetness of urine in the pissing-evil must be preceded by sweetness in the blood. Various surgeons in the seventeenth century explored the effects of extirpating the pancreas from dogs. Any dog which remained alive is unlikely to have had its pancreas completely removed, but reports on the survivors refer to polydipsia and polyuria, frequently observed in untreated diabetics. 

In addition, the presence of glucose in the tubules increases the osmotic pressure which pulls water from the blood into the tubule. Consequently, both glucose and water are lost from the body. This results in polyuria, dehydration, thirst and, hence, polydipsia. Indeed, it is these two symptoms that may persuade an unsuspecting diabetic to seek medical advice. 

Nephrogenic diabetes insipidus Administration of demeclocycline has resulted in appearance of the diabetes insipidus syndrome (polyuria, polydipsia, and weakness) in some patients on long-term therapy. 

Onset of type 1 diabetes mellitus usually occurs within the first two decades of life presenting symptoms Include hyperglycemia, polyuria, polydipsia, and polyphagia (excessive urination, thirst, and appetite, respectively), often with serious ketoacidosis in response to a stressor such as a viral infection. 

The characteristic symptoms of diabetes include excessive thirst, polyuria, pruritus, polydipsia with otherwise unexplained weight loss, and often symptoms from one or more of its related complications. Type 2 diabetes may be asymptomatic, so that the diagnosis is sometimes made as a result of abnormal screening tests on blood or urine. The onset of type 2 diabetes can occur up to 7 years before clinical diagnosis (see Harris et al., 1992). 

Deficiency of pituitary vasopressin (arginine vasopressin or AVP, also termed anti-diuretic hormone, ADH) causes the syndrome of polyuria, thirst and polydipsia termed cranial diabetes insipidus. It is... 

Because it is stable, desmopressin is preferred for treatments especially if pressor effects are not desired. The primary indication for therapy is central diabetes insipidus, a disorder that results when ADH secretion is reduced and that is characterized by polydipsia, polyuria, and dehydration. Desmopressin is also used to reduce primary nocturnal enuresis, or bedwetting, in children. It is useful in people with mild hemophilia A or with some types of von Willebrand s disease, in which von Willebrand s factor is present at low levels. In these cases, desmopressin is given when excessive bleeding occurs or before surgery to help reduce bleeding indirectly by increasing the amounts of coagulation factors. 

Dermatitis. Inflammation of the skin. Diabetes mellitus. A chronic syndrome of impaired carbohydrate, protein, and fat metabolism owing to insufficient secretion of insulin or to target tissue insulin resistance. Diabetes. A general term referring to disorders characterized by excessive urine excretion (polyuria), as in diabetes mellitus and diabetes insipidus. 

Urticaria, rash diabetes insipidus syndrome, marked by polydipsia, polyuria, and weakness (with long-term therapy). 

Lithium Neurological tremor, ataxia, seizures Endocrine hypothyroidism Cardiovascular T wave changes, sinus node dysfunction Renal polyuria, nephrogenic diabetic insipidus Dermatological hair loss, acne, psoriasis, rash Gastrointestinal nausea, diarrhea Miscellaneous fluid retention, weight gain, weakness... 

Polydipsia and polyuria are common but reversible concomitants of lithium treatment, occurring at therapeutic serum concentrations. The principal physiologic lesion involved is loss of responsiveness to antidiuretic hormone (nephrogenic diabetes insipidus). Lithium-induced diabetes insipidus is resistant to vasopressin but responds to amiloride. 

Vasopressin and desmopressin are treatments of choice for pituitary diabetes insipidus. The dosage of desmopressin is 10-40 meg (0.1-0.4 mL) in two to three divided doses as a nasal spray or, as an oral tablet, 0.1-0.2 mg two to three times daily. The dosage by injection is 1-4 meg (0.25-1 mL) every 12-24 hours as needed for polyuria, polydipsia, or hypernatremia. Bedtime desmopressin therapy, by intranasal or oral administration, ameliorates nocturnal enuresis by decreasing nocturnal urine production. Vasopressin infusion is effective in some cases of esophageal variceal bleeding and colonic diverticular bleeding. 

When a 45-year-old man with severe lithium-induced diabetes insipidus developed hyperosmolar, nonketotic hyperglycemia, it was suggested that poorly controlled diabetes mellitus may have contributed to the polyuria (684). Prior contact with a female patient who had developed hyperosmolar coma secondary to lithium-induced diabetes insipidus (685) allowed physicians 4 years later to treat her safely after a drug overdose and a surgical procedure, by avoiding intravenous replacement fluids with a high dextrose content (despite stopping lithium several years earlier, the patient continued to put out 10 liters of urine daily) (686). 

A 45-year-old man with a 4-year history of diet-controlled diabetes had hyperglycemia with polyuria, polydipsia, and blurred vision associated with the use of olanzapine 10 mg/day. Within 1 week after olanzapine was withdrawn his blood glucose returned to normal and insulin was discontinued. 

Diabetes insipidus A disease marked by increased urination (polyuria) and excessive thirst (polydipsia) due to inadequate production of antidiuretic hormone (ADH) and/or a decrease in the renal response to ADH. 

Medical conditions based in nearly all physiological systems can produce coincident sleep disturbances and sleep deprivation. This includes disorders of the cardiovascular (chronic heart failure), pulmonary (asthma), gastrointestinal (hepatic failure), renal (urinary tract infections, polyuria), endocrine (diabetes, hypothyroidism, hyperthyroidism), and neurological (Parkinson s disease,... 

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