Diabetes Insipidus and Diabetes Mellitus

WELCOME
Dr. S.Murugeshbabu,M.SC,M.SC,M.PHIL,ADA,M.D,PH.D,
Channels & Meridians Healthcare Pvt Ltd
Diabetes Insipidus
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S6+C17+A3+F1+R.E./W.E.
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 Diabetes Insipidus 
Diabetes insipidus (die-uh-BEE- teze in-SIP-uh- dus ) is
an uncommon disorder that causes an imbalance of
fluids in the body. This imbalance makes you very
thirsty even if you've had something to drink. It also
leads you to produce large amounts of urine.
 Diabetes Insipidus and
Diabetes mellitus
• What is difference between diabetes insipidus and
mellitus?
• Diabetes mellitus occurs due to insulin resistance
or insulin deficiency and subsequent high blood
glucose levels. Diabetes Insipidus on the other
hand develops as a result of the stilted production
of a hormone in the brain, which is released to
stop the kidneys producing so much urine in order
to retain water.
What is the most common cause of
diabetes insipidus?
Lithium is the most common cause of
acquired nephrogenic diabetes
insipidus. It's a medication often used
to treat bipolar disorder. Long-term
lithium use can damage the cells of
the kidneys so they no longer respond
to AVP.
What is difference between diabetes
insipidus and mellitus?
Diabetes mellitus causes high blood
glucose, or blood sugar, resulting from
the body's inability to use blood glucose
for energy. People with diabetes
insipidus have normal blood glucose
levels; however, their kidneys cannot
balance fluid in the body.
Diabetes insipidus
How do you diagnose diabetes
insipidus?
You may also need a blood test to assess
the levels of antidiuretic hormone (ADH)
in your blood. Your blood and urine may
also be tested for substances such as
glucose (blood sugar), calcium and
potassium. If you have diabetes
insipidus, your urine will be very dilute,
with low levels of other substances.
Why is it called diabetes
insipidus?
Diabetes
insipidus literally means
passing lots of insipid or
'tasteless' urine.
What are the 4 types of diabetes insipidus?
There are four types of diabetes
insipidus including:
Central or cranial diabetes insipidus, also
called neurogenic diabetes insipidus.
Nephrogenic diabetes insipidus.
Dipsogenic diabetes insipidus due to
malfunction of the thirst mechanism.
Gestational diabetes insipidus which
occurs during pregnancy.
Can drinking too much water cause
diabetes insipidus?
Primary polydipsia.
Also known as dipsogenic diabetes insipidus,
this condition can cause production of large
amounts of diluted urine. The
underlying cause is drinking an excessive 
amount of fluids.
Primary polydipsia can be caused by damage
to the thirst-regulating mechanism in the
hypothalamus.
How much water should a
diabetic insipidus drink?
Your GP or endocrinologist (a
specialist in hormone
conditions) may advise you to
drink a certain amount
of water every day, usually at
least 2.5 litres.
What happens if diabetes
insipidus is left untreated?
Without treatment, diabetes
insipidus can cause dehydration
and, eventually, coma due to
concentration of salts in the
blood, particularly sodium
.
Lithium is used to treat and prevent
episodes of mania (frenzied,
abnormally excited mood) in people
with bipolar disorder (manic-
depressive disorder; a disease that
causes episodes of depression,
episodes of mania, and other
abnormal moods). Lithium is in a class
of medications called antimanic
agents.
What are 3 uses of lithium?
The most important use of
lithium is in rechargeable batteries
for mobile phones, laptops, digital
cameras and electric
vehicles. Lithium is also used in
some non-rechargeable batteries
for things like heart pacemakers,
toys and clocks.
What food contains lithium?
Lithium in Food Products

The main sources of Li in the diet are

cereals, potatoes, tomatoes, cabbage, and
some mineral waters [ST14]. It may also be
found in some spices such as nutmeg,
coriander seeds, or cumin; however, their
share in the total supply of this element is
negligible in many geographic regions.
Do humans need lithium?
Lithium is a naturally occurring alkali
metal, which living organisms ingest
from dietary sources and which is
also present in trace amounts in
the human body. In much higher
concentrations, lithium is effective as
a medication for mania and mood
swings including manic depressive
disorders.
Why is lithium bad for humans?
Lithium may also cause irregular
heartbeat (H7), drying and thinning of
hair, alopecia, dry mouth, weight gain,
itchiness, and other side effects. Long-
term use may lead to kidney disease,
high blood calcium levels,
hyperparathyroidism, hypothyroidism or
other thyroid problems.
Chemistry World
Lithium carbonate | Podcast | Chemistry World
What is the drug lithium used for?
Lithium is a type
of medicine known as a mood
stabiliser. It's used to treat mood
disorders such as: mania (feeling
highly excited, overactive or
distracted) hypo-mania (similar to
mania, but less severe)
Lithium is approved by the US Food
and Drug Administration (FDA) as a
prescription medication for bipolar
disorder. It helps stabilize patients
quickly. It is also used in lower
amounts to prevent another
episode. No research has evaluated
the use of lithium supplements for
bipolar disorder.
What is lithium toxicity?
Lithium toxicity is another term for
a lithium overdose. It occurs when you
take too much lithium, a mood-
stabilizing medication used to treat
bipolar disorder and major depressive
disorder. Lithium helps reduce episodes
of mania and lowers the risk of suicide
in people with these conditions.
What drugs cause lithium toxicity?
The following three major drug classes
have been identified as potential
precipitants of lithium toxicity:
Diuretics that promote renal sodium
wasting.
Angiotensin-converting enzyme (ACE)
inhibitors that reduce glomerular filtration
rate (GFR) and enhance the tubular
reabsorption of lithium.
What are the 3 main symptoms of lithium
toxicity?
What are the symptoms of lithium toxicity?
diarrhea.
vomiting.
stomach pains.
fatigue.
tremors.
uncontrollable movements.
muscle weakness.
drowsiness.
What Is Diabetes Insipidus?
Diabetes insipidus is a rare
condition that causes your body to
make a lot of urine that is "insipid,"
or colorless and odorless. Most
people pee out 1 to 2 quarts a day.
People with diabetes insipidus can
pass between 3 and 20 quarts a
day.
Diabetes Insipidus vs. Diabetes
Mellitus
Diabetes insipidus is a different
disease from diabetes mellitus. Their
names are similar, but the only things
they have in common is that they
make you thirsty and make you pee a
lot.
If you have diabetes insipidus, the
hormones that help your body balance
liquids don’t work. Only one in every
25,000 people gets this condition.
With diabetes mellitus
(often shortened to
“diabetes”), your body
can’t use energy from food
like it should. It’s far more
common. Around 100
million Indians have type
1 or type 2 diabetes.
Symptoms of Diabetes Insipidus
Symptoms include:
•Severe thirst
•Peeing a lot (your doctor might call
this polyuria)
•Getting up to go a lot at night
•Preference for cold drinks
•Dehydration
•Weakness
•Muscle pains
•Irritability
Dehydration is another
symptom. You might
notice:
•Fatigue
•Feeling sluggish
•Dizziness
•Confusion
•Nausea
Symptoms in Infants and
Children
Many of the symptoms are similar
in younger people. In infants,
watch for:
•Crankiness
•Slow growth
•Poor feeding
In children, signs include:
•Drinking a lot of water
Molecular imaging of diabetes and diabetic
complications
•Peeing often,
sometimes every hour
•New bedwetting or
waking during the
night to pee
•Dehydration
Diabetes Insipidus Causes
Your body makes a hormone called
vasopressin in a part of your
brain called the hypothalamus. It’s
stored in your pituitary gland.
Vasopressin tells your kidneys to hold
on to water, which makes your urine
more concentrated. (Vasopressin is
also called antidiuretic hormone or
ADH.)
When you’re thirsty or a little
dehydrated, your vasopressin levels go
up.
Your kidneys absorb more water and
put out concentrated urine. If you’ve
had enough to drink, vasopressin
levels fall, and what comes out is clear
and diluted.
When your body doesn’t make enough
vasopressin, the condition is
called central diabetes insipidus. If you
make enough but your kidneys don’t
respond to it the way they should, you
have nephrogenic diabetes insipidus.
In either form, the
result is the same.
Your kidneys can't
keep water, so even
if you’re dehydrated,
they'll put out a lot of
pale urine.
SUGGESTED
Diabetes Insipidus Risk
Factors
Changes in the genes that
you inherit from your
parents can make you
more likely to get diabetes
insipidus. This happens in
1% to 2% of cases.
Types of Diabetes Insipidus
•Central diabetes insipidus. You get this when
damage to your hypothalamus or pituitary gland
affects how your body makes or puts out
vasopressin. Your kidneys remove too much fluid
from your body, and you pee more. This damage
can result from:
A tumor
A head injury
A blocked or bulging artery (aneurysm)
Diseases such as Langerhans cell histiocytosis
Infection
Inflammation
Surgery
•Nephrogenic diabetes insipidus. You
get this when your kidneys don’t
respond to vasopressin and take too
much fluid from your bloodstream.
Doctors don’t always know why it
happens, but some causes include:
A blocked urinary tract
Chronic kidney disease
High levels of calcium in your blood
Low levels of potassium in your blood
Some medications, like lithium
•Dipsogenic diabetes insipidus. This
type, also known as primary polydipsia,
happens when your body has trouble
controlling thirst. When you drink, the liquid
lowers the amount of vasopressin that your
body makes, while making you pee more.
Causes include damage to your
hypothalamus or pituitary glands from:
A tumor
A head injury
Infection
Inflammation
Surgery
•Gestational diabetes insipidus. You get
this type only during pregnancy.
Sometimes, a woman’s placenta -- the
organ that gives oxygen and nutrients to
your baby -- makes an enzyme that breaks
down vasopressin. Other pregnant women
make more prostaglandin, a hormone-like
chemical that makes their kidneys less
sensitive to vasopressin. Most cases of
gestational diabetes insipidus are mild and
don’t cause clear symptoms. The condition
usually goes away after birth, but it might
come back in another pregnancy.
Surgery
•Some medications or mental
health problems could make
you more likely to get
dipsogenic diabetes insipidus.
•Urinalysis. You’ll give a sample of
your pee, and your doctor will send it to
a lab to see whether it’s dilute or
concentrated. They can also check for
glucose, which can help them decide if
you have diabetes insipidus or diabetes
mellitus. You might need to collect your
pee over a 24-hour period to see how
much you’re putting out.
Blood test. This will
measure the electrolytes and
glucose in your blood. This
lets your doctor know if you
have diabetes mellitus or
diabetes insipidus. It may
help them figure out which
type.
•Fluid deprivation test.
This measures the changes
in your body weight, blood
sodium, and urine
concentration after you
don’t drink anything for a
while. There are two
types:
Short-form fluid
deprivation
test. Stop drinking for
a short time. Collect a
sample and take it
back to sends it to a
lab.
oYour blood pressure drops
too low or you have a rapid
heartbeat when you stand
oYou lose 5% or more of
your starting body weight
oYour urine concentration
goes up a little bit over two
or three measurements
•MRI. This test takes detailed
pictures your internal organs and
soft tissues. The doctor uses it to
see if there’s a problem with your
hypothalamus or pituitary gland.
•Genetic screening. Your doctor
may suggest this test if your family
members have had problems with
making too much urine.
Complications of
Diabetes Insipidus
Diabetes insipidus that
isn’t under control can
make you more likely
to have complications
like:
•Dehydration. Diabetes insipidus makes it
hard for your body to hold on to water. It’s
easy to get dehydrated.
•Electrolyte imbalance. Electrolytes
are minerals in your body with a tiny
electric charge. When you lose too much
water, your electrolyte levels can go up.
This might cause:
A headache
Feeling tired all the time (fatigue)
Irritability
Muscle pain
•Less sleep. Diabetes
insipidus can lead
to nocturia, a medical
name for waking up in
the night to pee. The
result: a less restful
night.
SUGGESTED
Diabetes Insipidus
Treatment
First, drink plenty of fluids.
That will replace the constant
loss of water. Other
treatments depend on which
type you have:
•Central diabetes
insipidus. You’ll take
medications
like desmopressin (DDAVP) or
vasopressin (Pitressin). It
usually comes as a nasal spray.
There are also treatments to
help these drugs work better.
•Nephrogenic diabetes insipidus can
be harder to treat. If it’s caused by a
drug, stopping the medicine helps.
Other medicines may ease symptoms.
These include indomethacin (Indocin)
and diuretics like amiloride (Moduretic 5-
50) or hydrochlorothiazide (Microzide).
Though diuretics typically make you pee
more, in this case, they help you make
less urine. Sometimes, this condition
goes away if you treat the cause.
Dipsogenic diabetes
insipidus. There’s no treatment for
this condition. But a few things can
ease symptoms. Suck on ice chips
or sour candy to help moisten
your mouth, boost saliva flow and
lower your desire to drink. If you
wake up to pee several times a
night, a small dose of
desmopressin at bedtime might
help but wont resolve.
Diabetes Insipidus Outlook
Diabetes insipidus doesn’t cause
kidney failure or lead to dialysis.
Your kidneys still do their main job,
which is to filter your blood.
But you will be more prone to
dehydration. Make sure you always
have something to drink close by,
especially when it’s hot or when
you exercise.
 TREATMENT : DIABETES INSIPEDUS

IST SITTING : ST36,ST35,T8 –Bilateral – BID -3 Days

2nd SITTING :LI18,T1,T2,T3,T7,ST12- OD -5 Days

3rd SITTING : T4,KD1,ST21,KD26 – Bilateral –BID- 2 Days

4th SITTING : (After 10 Days Gap) : 1+2(AM)+3(PM) = 3 Days

Follow Up –OD – 3 Days -6 Months

ST36,SP6,K1,K3,LIV3,T3
YIN-TANG / REN8 – OIL Palpate
 Dr. S.Murugeshbabu,
M.SC,M.SC,M.PHIL,ADA,M.D,PH.D,
Director-Healer-Therapist
Channels & Meridians Healthcare Pvt Ltd