Not diabetes mellitus

General characteristic of a disease

Not diabetes mellitus is the syndrome caused by deficit in a vasopressin organism. This substance is called still antidiuretic hormone. It is formed in a hypothalamus, collects in a hypophysis and is responsible for balance of liquids in an organism: blood, waters, extracellular liquid part, etc.

Not diabetes mellitus develops as a result of the pathologies of a hypophysis provoked by benign or malignant metastatic tumors. Other possible reason of destructive processes in a hypophysis – unsuccessful operative measures on a brain. Approximately each 5 case of not diabetes mellitus – an example of such unsuccessful neurosurgical operation.

Not diabetes mellitus is not a hereditary disease. However at a number of the autosomal and recessive inherited syndromes, for example, at the Tungsten disease the full or incomplete not diabetes mellitus is a part of a clinical picture of a genetic mutation.

Not diabetes mellitus – quite rare disease. It leaves no more than 0, 7% of all endocrine pathologies. Not diabetes mellitus is equally often diagnosed for women and men. At children not diabetes mellitus usually happens an inborn form though its diagnosis can happen late enough - after 20 years. The acquired disease form is more often diagnosed for adults.

Types of not diabetes mellitus

Except an inborn not diabetes mellitus children and the acquired form at adults can also have the central disease, renal or idiopathic.

Central not diabetes mellitus

The central or gipotalamo-pituitary not diabetes mellitus develops as a result of inability of kidneys to accumulate liquid. This pathology is caused by disturbances in work of distal tubules of nephron. As a result, the patient with the central not diabetes mellitus suffers from the speeded-up urination and a polydipsia – a syndrome of unquenchable thirst.

If the patient has an opportunity to drink unlimited number of liquid, practically nothing threatens him. At impossibility in time to satisfy thirst at the patient with not diabetes mellitus of this form severe dehydration (giperosmolyarny dehydration) develops. An extreme stage this of a syndrome – a life-threatening giperosmolyarny coma of the patient.

At it is long the current central not diabetes mellitus at the patient there is a renal nonsensitivity to artificially entered antidiuretic hormone. Therefore the earlier treatment of not diabetes mellitus of this form will be begun, the forecast is more favorable.

Besides, large amounts of the used liquid at not diabetes mellitus can lead to dyskinesia of bilious ways, a gastroptosis or development of a syndrome of the angry intestines.

Idiopathic not diabetes mellitus

A third of cases makes not diabetes mellitus of an idiopathic form. It means what during diagnosis of not diabetes mellitus at visualization of a hypophysis of any organic pathologies of body does not manage to be revealed.

Renal not diabetes mellitus

The disease is caused by receptor, enzymatic defect or organic pathologies of kidneys. Quite rare form of not diabetes mellitus at children usually happens inborn. It is provoked by mutations of a gene of aquaporin-2 or a receptor of vasopressin.

The acquired renal not diabetes mellitus at adults develops as a result of a renal failure of various etiology, long therapy by drugs of lithium, a hypercalcemia, etc.

Not diabetes mellitus symptoms

The main symptoms of not diabetes mellitus are the speeded-up urination (polyuria) and a syndrome of thirst (polydipsia). Expressiveness of these symptoms of not diabetes mellitus can be various intensity.

At incomplete deficit of antidiuretic hormone only insignificant manifestation of symptoms of not diabetes mellitus is possible. The acute beginning of a disease, on the contrary, is characteristic of an idiopathic form.

Clinical symptoms of not diabetes mellitus it is long the current form are:

• increase in the size of a bladder,
• extension and gastroptosis,
• hypotension (the lowered arterial pressure),
• symptoms of dehydration of an organism.

Children can have especially acute not diabetes mellitus symptoms, up to development of neurologic disturbances, sharp temperature increase, the exhausting vomiting, an incontience of urine and a giperosmolyarny coma.

Diagnosis of not diabetes mellitus

In diagnosis of not diabetes mellitus the test for a polyuria is applied. Normal the amount of the emitted urine should not exceed 3 l a day. Exceeding of these indicators, and also low density of urine are characteristic of urine of the patient with not diabetes mellitus.

The second test applied in diagnosis of not diabetes mellitus is called the test with xerophagia. The patient is recommended to abstain from drink within 8 hours. If for this span at the patient sharp decrease in body weight is observed, and density of urine does not exceed 300 ¼«ß¼/l, the diagnosis "not diabetes mellitus" is made to the patient.

Differential diagnosis of not diabetes mellitus assumes an exception of diabetes of an insulin-dependent form, organic pathologies of kidneys, mental and neurotic disorders, existence of tumors in gipotalamo-pituitary area.

Treatment of not diabetes mellitus

 At the heart of treatment of not diabetes mellitus replacement therapy by synthetic analogs of vasopressin. To the drugs capable to compensate the level of antidiuretic hormone in an organism, Desmopressin or Adiuretin carry. They are issued in the form of tablets or nasal sprays.

In treatment of not diabetes mellitus the tableted Desmopressin applies dosages to 0,4 mg of 3-4 times a day. Injection with synthetic vasopressin also has to be carried out not less than 3 times a day to a liquid nose.

In treatment of not diabetes mellitus also drugs with more long-term effect of action, for example, Pitressin Tanat are used. It is possible to apply it 1 time in 3-5 days.

An important role in treatment of not diabetes mellitus is played by a dietotherapy. All patients with deficit of antidiuretic hormone in an organism are recommended to eat and increase fractionally amount of complex carbohydrates in a diet (potatoes, vegetables, grain, bean, meat, nuts).

Stimulation of production of natural vasopressin at an incomplete form of not diabetes mellitus is carried out by the drugs Chlorproramidum and Karbomazepin.

Surgical treatment of not diabetes mellitus – an oncotomy and, in case of need, radiation exposure is shown to patients with a tumor of a hypophysis.