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Most Common Causes of SIADH in Elderly (CDP and NHR)* Medications Idiopathic form Malignancies *Aging Clin Exp Res 2003, 15:6-11.
Guiding Principles in the Treatment of Hyponatremia 1.Neurologic disease can follow both the failure to promptly treat as well as injudiciously rapid treatment of hyponatremia. Calculating Sodium Requirement in Hyponatremia In correcting hyponatremia the approximate expansion of total body water must be determined first by calculating the volume of water which was required to dilute the serum sodium concentration to its observed value. Steps in Evaluation of Hypernatremia Establish history of water intake, and integrity of thirst mechanism a Severe hypernatremia is unusual unless thirst mechanism is defective or water is not available to the patient.
Nephrogenic diabetes insipidus is a disorder in which a defect in the small tubes (tubules) in the kidneys causes a person to pass a large amount of urine. Diabetes insipidus is a medical condition in which the kidneys are unable to retain water in the body.
Frequent and excessive thirst is noted as an important symptom in diabetes insipidus diagnosis. Diabetes insipidus diagnosis may reveal either a case of central diabetes insipidus or nephrogenic diabetes insipidus, based on the activity of ADH.
Central diabetes insipidus can be the result of a deficiency of ADH, while nephrogenic diabetes insipidus usually results when the kidneys do not function properly in response to ADH. Due to the disturbed sleep pattern, he may feel tired all the time and also experience difficulty in carrying out routine activities. A person with diabetes insipidus can end up feeling vaguely unwell most of the time for no apparent reason. It is quite challenging to identify the symptoms of diabetes insipidus in children, as most of them cannot express their symptoms. An observation of a constant sense of fatigue and malaise can help in the diagnosis of diabetes insipidus. Children with diabetes insipidus may suffer from continued weight loss, vomiting, and diarrhea if the condition is left untreated. Gestational Diabetes Mellitus (GDM) is a condition characterized by an increase in blood sugar levels during pregnancy.
GDM can be caused by the dysfunctioning of the beta cells (cells that secrete insulin) of the pancreas.
A study conducted in women with gestational diabetes mellitus revealed the presence of self-destructing (autoimmune) antibodies. This is a major factor that triggers gestational diabetes mellitus, as the body’s sensitivity to insulin decline with the progress of the pregnancy. Studies have revealed increased circulating levels of leptin and the inflammatory markers TNF-? and C-reactive protein, and decreased levels of adiponectin in women with gestational diabetes mellitus.
As gestational diabetes causes are varied, all women are advised to undergo screening for GDM. If GDM is left untreated, it can cause various complications both during and after the pregnancy. As the causes of gestational diabetes are varied, it is advisable for every pregnant woman to undergo screening for GDM.
Diabetes mellitus is a disease that results due to insulin deficiency, and like humans, even dogs may be affected by this condition. Reports say that there is a three-fold increase in number of dogs diagnosed to be diabetic in last thirty years. It should be noted that the symptoms of diabetes in dogs are almost the same as those in humans. Diabetes generally affects all breeds of dogs, but certain breeds like German Shepherds, Poodles, Miniature Schnauzers, and Golden Retrievers are affected at a comparatively higher rate.
Diabetes causes hyperglycemia, which is marked by high blood glucose levels – a characteristic feature of diabetes. As the condition progresses, the symptoms of diabetes in dogs also turn complex and serious in nature. This is a serious complication of diabetes, so if you have any reason to suspect that your dog has ketoacidosis, find a veterinarian immediately. Inadequate sugar utilization necessitates the formation of ketone bodies, which act as alternative sources of energy. It manifests clinically as an odor in the breath, and typically smells like a nail polish removing solution. Diabetic dogs are especially prone to urinary tract infections, and mouth and gum infections. The lens of eye is a transparent structure, but diabetes makes it susceptible to cataract (and the lens becomes opaque). Once you note such symptoms, doctors will be able to confirm the presence of diabetes through various tests and laboratory findings. Keeping an eye out for the symptoms of diabetes in dogs can help you save your dog and seek immediate consultation from veterinarians when there is a problem. While planning a canine diabetes diet, you should first understand the basic metabolic interaction of carbohydrates.
The dosage of insulin to be taken and the frequency of the dosage largely depend on the body’s carbohydrate tolerance. Diabetic dogs usually have low levels of insulin in their body, and for this reason, carbohydrates have to be supplemented cautiously in their diet as they contribute towards excessive blood sugar.
Simple carbohydrates (like propylene glycol, sugars) are easily broken down by the body, causing a steep rise in blood sugar.
Complex carbohydrates are slowly digested and so, the blood sugar levels do not rise abruptly.
The glycemic index is a measure of the effects of dietary carbohydrates on blood sugar levels. Foods like whole wheat products, honey, sweet potatoes, sucrose, and brown rice fall under the Medium Glycemic Index category. Charts that display the glycemic indices of various food products are commercially available, and you can use these while framing a canine diabetes diet. Proteins do not raise blood sugar levels abruptly, so you can increase the protein content in order to cut down on the carbohydrates. Like most diabetic dogs, if your dog is overweight, food items that contain fat should be restricted. Fibrous foods are extremely essential for the body, and there are two types of fibers involved. These are soluble fibers that are responsible for the formation of gases in the intestines.
As insulin dosages and carbohydrates are closely dependent, it is important to provide your dog extra treats between meals.
It is important to find the best food items that best suit your dog in order to plan the right canine diabetes diet. Keeping your body hydrated with plenty of fluids is highly recommended for diabetes insipidus treatment. The amount of water conserved in the body is controlled by the Antidiuretic Hormone (ADH), which is also called vasopressin.
Sometimes, the problem may be a result of drug usage, especially drugs like Lithium and Amphotericin B.
The common symptoms you may experience in diabetes insipidus are polyuria, polydipsia, and easy fatigability. Diabetes insipidus treatment measures can be divided mainly into two types – general measures and hormonal therapy. You could experience a drop in your body weight as well due to the amount of water lost from the body. As a precautionary measure, it is always advisable to carry an identification card if you suffer from diabetes insipidus. As discussed above, in some cases, diabetes insipidus can be the result of a deficiency of the anti diuretic hormone vasopressin. Sometimes diabetes insipidus can be controlled with drugs that stimulate the production of antidiuretic hormones such as chlorpropamide, carbamazepine, and clofibrate. In the case of people who suffer from nephrogenic diabetes insipidus, water pills (thiazide diuretics) may be used. Through these diabetes insipidus treatment measures, the disease can be effectively controlled and managed. Diabetes insipidus is a medical condition in which the kidneys are unable to retain water in the body, and this happens when there’s an Antidiuretic Hormone (ADH) deficiency. If you know what is diabetes insipidus, you might have heard that polydipsia is one of its symptoms. Sometimes, the condition may also result due to the use of drugs like Lithium and Amphotericin B.
The exact cause is not known in 30-50% of people who are affected by central diabetes insipidus. This type of diabetes insipidus results when the kidneys do not function properly in response to the antidiuretic hormone. Medications like lithium, amphotericin, gentamicin and loop diuretics can cause diabetes insipidus. An imbalance of electrolytes like hypercalcemia and hypokalemia can cause diabetes insipidus. Kidney related conditions like obstructive uropathy, chronic kidney disease, post-kidney transplant measures, and infections can cause the disease. Systemic processes like sarcoid, amyloid, multiple myeloma, sickle cell disease, and pregnancy can cause diabetes insipidus.
Once you’ve understood what is diabetes insipidus and how it’s caused, you should be aware of the symptoms of the disease, in order to spot it properly.


The estimation of urinary electrolytes like sodium, chloride, and calcium can help in diagnosing the condition. The rate at which the patient urinates over 24 hours is also noted, as the volume of urine will be significantly more in individuals with diabetes insipidus. The treatment measures can be divided mainly into two parts: general measures and hormonal therapy. This can be done through the proper intake of fluids and by choosing the right diet, with all the essential nutrients, which will help the body retain its weight. If you’ve correctly understood what is diabetes insipidus, you’ll remember that it’s caused by a hormonal deficiency. The medication used to treat this disorder is called Desmopressin Acetate (DDAVP), and this is similar to ADH. Other medications like Terlipressin, Lypressin, and Felypressin are similar to DDAVP and can be used too. Drugs like chlorpropamide, carbamazepine, and clofibrate help the body churn out more ADH, and these are used in some cases.
By understanding what is diabetes insipidus, you can watch out for the symptoms and stay informed so that immediate treatment measures can be taken in case the disease surfaces. Prediabetes is a condition in which people have glucose levels that are higher than normal, but not high enough to indicate diabetes. The Centers for Disease Control and Prevention (CDC) estimates that about 79 million people in the U.S. Family History: If one of your parents or siblings has diabetes, there are chances that you might be prediabetic. High Cholesterol: If the cholesterol level in your body is high, your chances of being affected by diabetes can rise significantly.
Sedentary Lifestyle: If you follow a sedentary lifestyle without much exercise, you have a strong risk of developing prediabetes. Obesity: When your body mass index is greater than 25, there will be a subsequent decrease in the peripheral utilization of insulin, which might lead to diabetes at a later stage. High Risk Ethnic Group: People who belong to Aboriginal, South Asian, Asian, African, or Hispanic backgrounds face an elevated risk of being prediabetic.
History of Gestational Diabetes: Women who face diabetes during pregnancy (also called gestational diabetes) can often experience prediabetic symptoms. Classic Diabetes Symptoms: The primary symptoms of diabetes, including increased hunger and thirst, loss of appetite, and a weak immune system, can together indicate the presence of prediabetes in an individual.
Two-Hour Oral Glucose Tolerance Test [OGTT]: This test is run after the individual is made to ingest a standardized 75 gm glucose solution.
Glycated Hemoglobin Level: The American Diabetes Association’s current guidelines promote the evaluation of Glycated Hemoglobin as a vital part of prediabetes diagnosis.
Dietary modification plays a vital role in the management of diabetes, and framing a diabetes diet is an essential step that should be taken.
A good diabetes diet can add on to the advantages of the medical treatment, as it will help in keeping the blood sugar levels under check. Fruit punch, fruit drinks, sweetened soda, desserts, sweets, confectionery, jams, and jellies are the commonly consumed food items with high sugar content, so these have to be consumed in small quantities. Consuming these in large quantities can raise blood sugar levels, and this can lead to long term complications.
People who live in an urban setting, including diabetics, resort to canned foods as they are ready to eat and take less time to prepare.
Excessive sodium leads to an increase in the blood pressure, and high blood pressure along with diabetes often leads to blood vessel damage and heart disease.
Fried foods are high in calories and low in nutrition, and consuming a high calorie diet can naturally lead to weight gain.
Fried food contains a lot of dietary fat, which makes the management of diabetes a tad difficult.
An excess of calories can lead to obesity, which can cause further serious complications for diabetics. Whole milk, regular yogurt, regular cottage cheese, butter, and ice-creams are to be avoided while framing a diabetes diet, as these are very rich in calories. Beverages such as sodas, beer, sweetened tea, coffee with sugar and cream, chocolate drinks, and energy drinks should not be included in a diabetes diet. Alcohol can be consumed in moderate quantities, but only if blood sugar levels are well-controlled.
For this reason, excessive drinking can lead to an increase in weight, affecting the bodily balance in diabetics. Diabetes is a chronic condition, and it can be managed only if stringent dietary guidelines are followed. Dietary modification in the form of a complete diabetes diet plan plays a vital role in the management of the condition. Following such a diet adds on to the advantages of insulin therapy treatment by keeping the blood sugar levels under check. The other two major nutrients, protein and fat, also have an effect on blood glucose levels, though it is not as rapid or great as the effect that carbohydrates have. In diabetes it is important to keep the carbohydrate content of the diet consistent from day to day.
The golden rule in planning a diet is to ensure that your blood sugar levels do not shoot up. The glycemic index provides a measure of how quickly blood sugar levels rise after eating a particular type of food. Commonly used food items with low glycemic index are beans, whole grains like wheat, brown rice, and oats.
While framing your diabetes diet plan, you can include the following foods, due to the advantages specified below each item. Learning about type 2 diabetes symptoms is essential as this will help in speeding up the diagnosis and treatment for the condition. Type 2 diabetes mellitus, also called Non-Insulin Dependent Diabetes Mellitus (NIDDM), occurs in people whose bodily ability to utilize insulin in their peripheral tissues (like muscles, fat, and liver) is low. This type of diabetes is also associated with family history of diabetes and other factors like obesity, a sedentary life that lacks exercise, and old age.
Type 2 diabetes is a form of adult onset diabetes which generally occurs after the age of 40 years.
Frequent Urination, Thirst, and Dry Mouth: People who suffer from type 2 diabetes mellitus feel the need to urinate frequently, and as a result of dehydration, experience dry mouth and thirst. Increased Hunger: As cells are unable to absorb the insulin in the blood, diabetics are bound to feel hungry often.
Unexplained Weight Loss: Since the cells can’t utilize glucose, unexplained sudden weight loss is a key sign that the condition exists. Fatigue: Lack of energy to do day-to-day tasks is another significant sign of type 2 diabetes.
Blurred Vision: The blood vessels in the eyes are affected by excessive glucose and retinal damage due to this is another common symptom.
Frequent Infections of the Skin, Urinary Tract, or Vagina:  Elevated blood sugar levels lead to an increased amount of glucose in all body secretions. Apart from these type 2 diabetes symptoms, there are other risk factors that can lead to the condition. Those With Pre-Diabetes Conditions:  Pre-diabetes is a condition in which the blood sugar levels are on the borderline. Those With A Stressful Lifestyle: People who are aged above 40 years and have stressful or sedentary jobs are at risk for type 2 diabetes. Those With Increased Body Mass Index: The Body Mass Index (BMI) is an anthropometric index of general obesity which is calculated by using one’s height and weight.
Those With Increased Waist Circumference (Central Obesity): Measuring the circumference of the waist is a simple procedure that can be done at home. Women With History of High Blood Sugar During Pregnancy: Women who have had high blood sugar during pregnancy are at a greater risk of developing type 2 diabetes later. Treatment should be started immediately once these type 2 diabetes symptoms are detected and diagnosed.
It is characterized by normal kidney function, high urine OSMOLALITY, low serum osmolality, and neurological dysfunction. ADH or Anti Dieuretic Hormone, also known as vassopressin, controls the amount of water conserved by the body. The amount of urine passed can range from 3 liters in mild cases to up to 20 liters in severe cases. The frequency of urination is as high as 15-20 minutes.
Diabetes insipidus diagnosis becomes twice as difficult in children who have not learnt to speak. If an adult with the condition has not been treated, he can still remain healthy as long as he compensates for the persistent loss of water from the body. While the causes of gestational diabetes can affect any pregnant woman, there are some factors that make certain women highly susceptible to the condition. Some of the important genes involved in this process are glucokinase, hepatocyte nuclear factor 1?, and the insulin promoter factor 1. Increased content of fat in the liver and muscle has also been reported in women with a history of gestational diabetes.
By keeping an eye out on the clinical symptoms of diabetes in dogs, you can ensure that your four-legged friend is always healthy. In most cases, the main cause behind the condition is the immunological destruction of insulin producing cells of the pancreas. Over 70 percent of the affected dogs are above seven years of age, at the time of diagnosis.


These ketone bodies are the by-product of metabolic reactions in the body, and excess levels of such ketones in the blood can be detected in the laboratory to ketoacidosis. High levels of blood sugar facilitate the growth of infectious germs, and obvious symptoms like lethargy and vomiting generally point to infection.
Long term blood sugar fluctuations can cause damage to the kidneys, bringing about renal failure with time. Statistics reveal that only 50% of diabetic dogs survive for at least 2 months after diagnosis, with continued successful treatment at home. The right diabetes diet for dogs will mainly involve regulated amounts of carbohydrates, fats, and proteins, along with some fiber content. Blood glucose levels typically rise after meals, and for this reason, the need for insulin is increased. The doses of insulin that you provide to your dog and the amount of carbohydrates to be supplemented largely depend on each other. It measures the rise in blood sugar per gram of carbohydrate in food, with respect to its rise due to glucose.
Fresh vegetables, fruits, grains, and legumes are examples that can be immediately added to any diabetes diet. These foods cause a rapid rise in blood sugar levels after their consumption and should be avoided. Foods that are based on cereals and pulses are rich in protein, and fishes, meat are protein-rich foods too.
Obesity is the main culprit in canine diabetes, as fat accumulates and increases the body weight, posing risk to your canine. L-carnitine is an amino acid that improves the breakdown of fats and helps maintain the body mass. The bacteria present in the colon ferment and produce gases, and excess gas can speed up the absorption of glucose.
They swell up by absorbing water, so you should provide adequate water to your dog to prevent the risk of constipation. The contents of commercially available diabetic dog foods usually have rich protein, high fiber, and complex carbohydrates. Before you check out the various diabetes insipidus treatment options, it is essential to understand the condition first.
Diabetes insipidus often results due to ADH deficiency, and in such cases, it is called Central Diabetes Insipidus. This card should have information about your name, address, the medical condition that you have, and the medications you are taking. Thiazide diuretics have been shown to stimulate the production of a hormone that helps the body retain salt, and this additional salt prevents the loss of water in the body. It is important to follow your physician’s instructions before proceeding with these measures.
The hormone helps the body retain water, and changes in its level can affect the body adversely. This can occur due to electrolyte imbalance, medications, systemic processes, and even kidney disease.
There are medicines that can help in generating this hormone, and these can be used for hormonal therapy. Doctors might also prescribe medication that helps your body retain salt, as this can in turn help the body retain water.
The number of prediabetic people is increasing worldwide, and usually, the glucose levels in such people start rising 7 to 10 years before the clinical diagnosis of diabetes. High levels of LDL and VLDL (bad cholesterol), or low levels of HDL (good cholesterol) can indicate a high chance of you being prediabetic.
At this age, it is advisable to get health checkups done at regular intervals, in order to detect such problems. Mainly, if the weight of the newly born infant is greater than 9 lb (4 kg), the chances of prediabetes in the mother is very high.
It signals the likely onset of a more serious problem, so if you’re prediabetic, you should take the hint and work towards maintaining and improving your health. The American Diabetes Association recommends cutting back on high-calorie snacks and desserts, as these should only be consumed in moderation. Such food items don’t increase the blood sugar levels beyond acceptable normal levels and long term complications of diabetes can in turn be prevented. Alcohol is processed in the body just like how fat is processed, and alcohol generates almost as many calories as fatty food items. You can include green and leafy vegetables and a whole lot of natural products in your diabetes diet – but ensure that you stay away from the above food items! Information on this will help in determining the amount of insulin to be taken to maintain blood sugar control. A balance of carbohydrate intake, insulin, and physical activity is necessary for the keeping blood sugar levels constant. To control this, it is important to consume foods that have low glycemic index and other low calorie foods. Carefully framing a diabetes diet plan with your physician’s inputs will definitely help in this regard. Type 2 diabetes is also associated with a defect in the beta cells’ ability to secrete insulin.
It can appear at an earlier age as well in people who don’t get enough physical exercise.  Treatment options in this type of diabetes include diet modifications in the form of a low calorie diet, proper exercise, weight reduction techniques, oral medications, and insulin as well. Males who have a circumference of more than 90 cm and females who have a circumference of more than 85 cm are at risk. Etiologies include ADH-producing neoplasms, injuries or diseases involving the hypothalamus, the pituitary gland, and the lung. 3.Acuity or chronicity of the electrolyte disturbance impacts the rate at which the correction should be undertaken.
ADH normally tells the kidneys to make the urine more concentrated. As a result of the defect, the kidneys release an excessive amount of water into the urine, producing a large quantity of very dilute urine.
Diabetes insipidus diagnosis is based on the observation of the clinical diabetes insipidus symptoms and the results of laboratory tests.
In such cases, parents can make the diagnosis easier by looking for the following symptoms in their child. Due to the presence of these antibodies, the insulin secretion is inadequate and fails to match the increased insulin demand that is seen during pregnancy. Detailed metabolic studies have revealed abnormalities in glucose-mediated insulin secretion due to mutations in these genes. Genetic predisposition is also an important factor when it comes to the symptoms of diabetes in dogs.
Dogs that are being treated for diabetes have the same life expectancy as non-diabetic dogs, so help your canine friend counter the condition. If you keep the dietary carbohydrates steady, insulin needs can also be maintained steadily.
High soluble fiber supplements can cause diarrhea and abdominal discomfort in your dog, so soluble fibers should be avoided.
The side effects of insoluble fibers include vomiting, voluminous stools, flatulence, and retarded absorption of other nutrients.
Examples of such snacks include dehydrated meat pieces, dried salmon, freeze-dried liver, and dried beef tendons.
It might also occur when the kidneys do not function properly in response to ADH, and in such cases, it is called Nephrogenic Diabetes Insipidus. The medication used to treat this disorder is called desmopressin acetate (DDAVP), which is similar to the antidiuretic hormone (ADH). If the value crosses the cut-off point of 6.5%, the individual can be classified as diabetic. Such abnormalities can lead to a decrease in insulin secretion and in turn lead to gestational diabetes mellitus. However, it is also very important that you do not drink too much water, as excessive water consumption can cause serious side effects. Congenital diabetes insipidus is present at birth as a result of an inherited defect that usually affects men, although women can pass the gene on to their children. Most commonly, nephrogenic diabetes insipidus develops because of other reasons. It is best to seek timely diabetes insipidus diagnosis and subsequent treatment for the condition to ensure optimal health. There are newer medications like Terlipressin, Lypressin, and Felypressin which are similar to DDAVP.
You will produce large amounts of urine, usually more than 3 - 15 liters per day. If you do not drink enough fluids, dehydration can result. The amount of fluids given should be about equal to the amount of urine produced. If the condition is due to a certain medication, stopping the medicine may improve symptoms. Never stop taking any medication without first talking to your doctor. A medicine called hydrochlorothiazide may improve symptoms.




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