Diabetes Case Study

Diabetes Case Study-21
The latter is usually referred to as primary polydipsia and is most often caused by an abnormality in the part of the brain that regulates thirst.This subtype is difficult to differentiate from pituitary DI particularly since the two disorders can result from many of the same brain diseases.

The latter is usually referred to as primary polydipsia and is most often caused by an abnormality in the part of the brain that regulates thirst.This subtype is difficult to differentiate from pituitary DI particularly since the two disorders can result from many of the same brain diseases.Desmopressin stimulation Test –To distinguish between the main forms,desmopressin stimulation is also used; desmopressin can be taken by injection,a nasal spray, or a tablet.

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The main effector organ for fluid homeostasis is the kidney.

ADH acts by increasing water permeability in the collecting ducts and distal convoluted tubule, specifically it acts on proteins called aquaporins which open to allow water into the collecting duct cells(figure-3).

His physician remarked that the kidneys were not concentrating urine normally.

Case discussion- The patient is suffering from Diabetes Insipidus.

Excessive excretion of diluted urine with a low osmolarity and history of head injury are all suggestive of diabetes Insipidus.

Head trauma is one of the most common causes of diabetes Insipidus, particularly if the posterior pituitary stalk is disrupted.

3) Nephrogenic DI -The third type of DI is caused by an inability of the kidneys to respond to the “antidiuretic effect” of normal amounts of vasopressin.

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, partial blockage of the ureters, and inherited genetic disorders.4) Dipsogenic DI –The fourth form of DI occurs when vasopressin is suppressed by excessive intake of fluids.

Central DI and gestational DI respond to desmopressin, a synthetic analogue of ADH.

Gestational DI tends to abate on it sown 4 to 6 weeks following labor, though some women may develop it again in subsequent pregnancies.

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