Diabetes Insipidus Nutritional Implications

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Diabetes Insipidus

Abstract
This paper covers the basic pathophysiology of the disease process for diabetes insipidus. It is also a preview of the most common symptoms of the disease, and the treatments associated with it. One treatment is vasopressin which is an antidiuretic. Another treatment option is Chloropropamide which is used to aid in the control of diabetes mellitus type two, but can also be used to aid in the assistance of controlling diabetes insipidus. Lastly there are also many important diet restrictions and limitations that a patient must fallow. Diet is an important part of managing the disease process and could have a significant impact on the control of the disease process.

“Diabetes insipidus is an uncommon disorder characterized by intense thirst and the excretion of large amounts of urine (polyuria). In most cases, it's the result of your body not properly producing, storing or releasing a key hormone, but diabetes insipidus (DI) can also occur when your kidneys are unable to respond properly to that hormone. Rarely, diabetes insipidus can occur during pregnancy (gestational diabetes insipidus).” (Mayoclinic, 2011). Regardless of the similarities in their names diabetes insipidus is not related to diabetes mellitus. Diabetes mellitus is either the lack of or improper use of insulin. The different kinds of diabetes insipidus include central diabetes insipidus, nephrogenic, dipsogenic, gestational. “central diabetes insipidus, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. Damage to the pituitary gland can be caused by different diseases as well as by head injuries, neurosurgery, or genetic disorders.” (Medicinenet, 2012). The can be treated with the hormone desmopressin. “Nephrogenic diabetes insipidus results when the kidneys are unable to respond to ADH. The kidneys' ability to respond to ADH can be impaired by drugs- like lithium, for example-and by chronic disorders including polycystic kidney disease, sickle cell disease, kidney failure,” (Medicinenet, 2012). This type of diabetes insipidus is treated with hydrochlorothiazide (HCTZ) or indomethacin. “Dipsogenic diabetes insipidus is caused by a defect in or damage to the thirst mechanism, which is located in the hypothalamus. This defect results in an abnormal increase in thirst and fluid intake that suppresses ADH secretion and increases urine output.” (Medicinenet,2012). This type of diabetes insipidus has no cure, however those that have it should avoid the hormone desmopressin because it will cause an increase in thirst. “Gestational diabetes insipidus occurs only during pregnancy and results when an enzyme made by the placenta destroys ADH in the mother. The placenta is the system of blood vessels and other tissue that develops with the fetus. The placenta allows exchange of nutrients and waste products between mother and fetus.” (Medicinenet, 2012). Most cases of gestational diabetes insipidus can be treated with desmopressin. Some health care providers often mistake diabetes inspidus for diabetes mellitus due to the similarity in symptoms. Diabetes insipidus can be diagnosed using a urinalysis, a fluid deprivation test, and in some cases an MRI. (Medicinenet,2012).

Vasopressin (Pitressin) is an antidiuretic hormone that acts on the kidneys and blood vessels, often used in the treatment of diabetes insipidus. Vasopressin helps prevent water loss by reducing urine output and helping the kidneys reabsorb water (Drugs.com, 2012). This drug can be administered subcutaneously (sub-q), intramuscularly (IM), or intravenously (IV). The onset and peak are unknown for all routes but the duration for sub-q and IM is 2-8 hours and 30-60 minutes for IV (Deglin, Vallerand, & Sanoski, 2009). The recommended dose for adults via sub- q or IM is 5-10 units 2-4 times daily; IV 0.0005 units/kg/hour, double dosage every 30 minutes as needed to a maximum of...
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