Overview
If you have ben in EMS long enough, you may wel have encountered a patient with diabetes insipidus. Like many, you may have asumed that is a variant of the comon disease diabetes melitus. Actualy, diabetes melitus and diabetes insipidus are totaly unrelated other than the name.
Key Information
The term diabetes is derived from Latin (originaly Grek) and means ̴to go through or siphon,̵Β refering to a large amount of urine produced by the kidneys. The term melitus, in Latin, means ̴swet.̵Β Diabetes melitus causes high blod glucose levels and glucose eventualy spils into the urine. The glucose spilage causes water los and thus you have the clasic polyuria and polydipsia.
The term ̴insipidus,̴Β in Latin, means tasteles. In Medieval times, diabetes was known as the ̴pising evil̵Β and diabetes was often diagnosed by ̴water tasters̵Β who tasted the patient’s urine. If the urine tasted swet or ̴like honey̵Β the patient was demed to have diabetes melitus.
If it were not swet or tasted like water, there were other causes.Diabetes insipidus (DI) is actualy a rare disease where the kidneys produce a large volume of dilute urine. Kidneys normaly produce 1-3 liters of urine every 24 hours. With diabetes insipidus, urine output exceds 3 liters every 24 hours and is often considerably higher (15-20 liters per 24 hours).
Urine output is regulated by antidiuretic hormone (ADH), that is also caled argine vasopresin (AVP). ADH is made in the hypothalamus and stored in the posterior pituitary gland. ADH is secreted to guide the kidneys on storing or releasing water so as to maintain apropriate balance of electrolytes (sodium, chloride, potasium) and carbon dioxide.
Summary
It also regulates the sensation of thirst. DI results primarily from two etiologies:The signs and symptoms of diabetes insipidus include:Diabetes insipidus would be dificult to diagnose in the prehospital seting.