Diabetes Insipidus and ADH deficiency

Diabetes Insipidus and ADH Deficiency

One of the problems with you and me is the fact that we are lay people. I have some training but not at the level of a Diabetologist.

One of the symptoms of diabetes, already discussed on this blog, is the out-put of hugh amounts of urine and intense thirst. This condition is called (diabetes = overflow; insipidus = tasteless) distinguishes it from diabetis mellitus (mel = honey), in which insulin deficiency causes large amounts of blood glucose to be lost in the urine. In the past, urine was tasted to determine which type of diabetes the patient was suffering from.

The possible causes of diabetes insipidus can be caused by a blow to the head that damages the hypothalmus or the posterior pituitary. In either case, anti-diuretic hormone (ADH) release is deficient. Though inconvenient, the condition is not serious when the thirst center is operating properly and the person drinks enough water to prevent dehydration.

 Another reason people who are unconcious or comatose with head injuries are carefully monitored for excessive dehydration that can be life threatening.

This is a good time to defer to a Diabelologist, on your next visit, to answer some of your more involved questions on similar symptoms that may not be due to diabetes mellitus.

Diabetic Camps - Nationwide Experience and Education

Diabetic Camping Experiences

Many years ago Camp Midicha ,in Michigan, and Camp Needle Point in Wisconsin provided wonderful experiences in outdoor camping and fun from a variety of activities that many children took for granted.

Supervised by a full staff of physicians, nurses and counselors trained in the care of diiabetic children between the ages of six and sixteen, these camps were an instant hit.

The camp counselors were, back then, split between those with diabetes and those without diabetes. Insulin use was closely monitored because the increased exercise made their pre-camp dosage of insulin too high for camp activities. Adjustments were made and camp fun continued unabated.

At the same time as their children were attending camp the parents attended a learning session in Minnesota, at the International Diabetes Center in St. Louis Park, Minnesota.

There, many topics were covered that enabled both the parents and children to have a deeper and significant understanding of the nature, treatment and future of diabetes in their lives together.

Here is a link on the Diabetic Camps nationwide that provide camping experiences for diabetics.

Help From Biotechnology for Diabetes Mellitus

Biotechnology Help for Diabetes Mellitus

Current research has indicated that up to four injections per day of insulin is protocol. Even better, an insulin pump to reduce vascular and renal complications of Type I diabetics.

Now, if you add a glucose sensor and a miniature computer to an insulin pump you have just manufactured an artificial pancreas that would dispense insulin as needed.

Mist inhalers and insulin patches are other methods of administering insulin.

Pancreatic Islet Cell Transplants are increasing in their ability to help Type I diabetics. The limiting factor in islet transplantations is the need for long-term immunosuppression.

The side effects from immunosupressant drugs may cause complications. Thus, pancreatic islet transplantations are only used for patients that cannot control their diabetes any other way.

For those of you that have Type II diabetes the worry about ketoacidosis is far less but the other complications that afflict Type I diabetics still exist for you. Heredity or a familial predisposition is very strong for Type II diabetics. An estimated 25 to 30 percent of Americans carry a gene that predisposes them to Type II diabetes, with non-white populations at a far greater risk.

Most Type II diabetics produce insulin but the insulin receptors on body cells are unable to respond to it, a phenomenon called insulin resistance. Mutations in any one of several genes could lead to insulin resistance. One example is a gene called PC-1. That gene, a membrane protein gene, causes that membrane protein to react strongly to insulin receptor that prevents the receptor from being activated.

Lifestyle can play a role. Diabetics are almost all overweight and sedentary. Adipose cells of obese folks overproduce a number of hormone-like chemicals including tumor necrosis factor alpha and adiponectin which may alter the cascade sequence triggered by insulin binding that makes it possible for your body cells to absorb glucose for metabolism.

The good news is that many Type II diabetics can control their diabetes by exercise, weight loss and a healthy diet. Some diabetics benefit from oral medications like Orinase. There is a number of drugs that are referred to as insulin resistance reducers such as Avandia.

Polyuria, Polydipsia and Polyphagia - Three Signs of Diabetes

Polyuria, Polydipsia and Polyphagia

We know that excess glucose in the blood that doesn't go away without some help is diabetes. This is how the three signs above are created in diabetes.

The excess glucose in the urine filtrate acts as an osmotic diuretic. Wow! big words again for us to master. 

First, a simple definition of osmosis that will never get you into trouble, well seldom, never is an impossible situation.

Osmosis is the movement of water through a selective permeable membrane (think cell membrane if you have a tiny mind like me!)from an area of low solute concentration (anything dissolved in water (the solvent) into a area of high solute concentration.

In this illustration, due to the large amount of excess glucose in the filtrate, (what the kidney filters from the blood under pressure) the glucose is the "solute molecule" and causes the concentration of solutes in the kidney filtrate to be higher than the solute concentration in the blood. Net result, instead of water being returned to the blood it is flushed out of the body in the urine! Thats called diuresis.

A diuretic, in this case, is something that inhibits water reabsorption by the blood from the kidney tubules that results in a hugh urine output that is called Polyuria.

The polyuria results in decreased blood volume and dehydration. Thats why a diabetic person experiences excessive thirst. Lets look at how that "thirst" occurs technically.

Along with water loss, which is a solvent, serious electrolytelosses also occur as the body rids itself of excess ketones.

The ketone bodies are negatively charged particles called ions. Keep in mind a balance is maintained between positive and negative ions in the body. But, in mass movements involving negative charged ketone bodies, they attract and carry positve charged ions like sodium (Na+) and potassium (K+)out of the body fluids as well. 

This creates an electrolyte imbalance in you, if you are a diabetic out of control. Because of this imbalance you get abdominal pains and may vomit, and the stress reaction  ("flight, fright and frolic") about diabetes mellitus just accelerates even more.

Vomiting expels even more water from the body and carries with it more important electrolytes. This rapid water loss, or dehydration, stimulates the hypothalmic thirst centers causing polydipsia or excerssive thirst.

If the general body cells cannot take up glucose for metabolism to take place you develop excessive hunger pangs and increase your food consumption accordingly. This is called polyphagia. You sense, correctly, that you are starving to death. Although you have plenty of glucose available, it cannot be used, and the body begins to use the fat and protein stores for metabolism.

If you are a Type I Diabetic you can develop long term vascular and neural problems. The lipidemia and high blood cholesterol levels, characteristic of the disease, can lead to severe vascular complications like atherosclerosis, strokes, heart attacks, renal shutdown, gangrene and blindness.

Neural changes include loss of sensation, impaired bladder function and impotence.

Hope this helps with your understanding of the course that diabetes follows in a Type I diabetic.