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Causes of Diabetes
List of causes of Diabetes
Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Diabetes) that could possibly cause Diabetes includes:
- Metabolic syndrome - a syndrome with 4 key features (diabetes, hypertension, obesity/overweight, and high cholesterol).
- Insulin resistance
- Hemochromatosis - iron overload causes pancreas damage that can mimic Type 1 or Type 2 diabetes.
- Chronic pancreatitis - pancreas damage that can mimic diabetes.
- Polycystic ovary syndrome (PCOS) - ovary cysts inhibit natural female hormones causing insulin resistance
- Carcinoid syndrome - glucose intolerance, protean manifestations, serotonin inhibits insulin production
- Pancreas surgery
- Pancreas trauma (type of Pancreas conditions)
- Overactive pituitary gland
- Overactive adrenal glands
- Pancreatic insufficiency
- Acromegaly
- Cushing's disease
- Cystic fibrosis
- Adenocarcinomas
- Somatostatinoma
- Aldosteronoma-induced hypokalaemia
- Phaeochromocytoma
- Primary aldosteronism
- Wolfram's syndrome
- Leprechaunism
- Rabson-Mendenhall syndrome
- Insulin autoantibodies (IAAs) - can inhibit insulin and lead to insulin resistance.
- Type B insulin resistance - insulin receptor antibodies can inhibit insulin action.
- Stiff Man syndrome - about half have Glutamic Acid Decarboxylase (GAD) antibodies and get Type 1 diabetes.
More causes: see full list of causes for Diabetes-like symptoms
Diabetes as a complication of other conditions:
Other conditions that might have Diabetes as a complication may, potentially, be an underlying cause of Diabetes. Our database lists the following as having Diabetes as a complication of that condition:
- Acromegaly
- Adult Cystic Fibrosis
- Apolipoprotein C 2I deficiency
- Autoimmune Lymphoproliferative Syndrome
- Chronic Pancreatitis
- Cushing's syndrome
- Cystic Fibrosis
- Gigantism
- Hematochromatosis
- Hemochromatosis
- Hemochromatosis type 1
- Hemochromatosis type 2
- Hemochromatosis type 3
- Hemochromatosis type 4
- Hereditary Hemochromatosis
- Hereditary pancreatitis
- Hyperinsulinism due to glucokinase deficiency
- Hyperinsulinism, diffuse
- Hyperprolactinemia
- Hyperthyroidism
- Juvenile tropical pancreatitis syndrome
- Pancreatitis
- Physical inactivity
- POEMS
- Polycystic ovary syndrome
- Primary Hyperaldosteronism
- Prolactinoma
- Werner syndrome
- Wolfram's disease
- X-linked sideroblastic anemia
Diabetes as a symptom:
Conditions listing Diabetes as a symptom may also be potential underlying causes of Diabetes. Our database lists the following as having Diabetes as a symptom of that condition:
- Aceruloplasminemia
- Achard-Thiers Syndrome
- Acinic cell carcinoma
- Acquired total lipodystrophy
- Acromegaly
- Adrenal adenoma, familial
- Adrenal Cancer
- Adrenal Cortex Neoplasms
- Adrenal gland hyperfunction
- Adrenal incidentaloma
- Adrenocortical carcinoma
- Alcohol-induced pseudo-Cushing syndrome
- Anophthalmia - short stature - obesity
- Atherosclerosis, premature - deafness - diabetes mellitus - photomyoclonus - nephropathy - degenerative neurologic disease
- Atherosclerosis- deafness - diabetes - epilepsy - nephropathy
- Bardet-Biedl syndrome, type 1
- Bardet-Biedl syndrome, type 10
- Bardet-Biedl syndrome, type 11
- Bardet-Biedl syndrome, type 12
- Bardet-Biedl syndrome, type 2
- Bardet-Biedl syndrome, type 3
- Bardet-Biedl syndrome, type 4
- Bardet-Biedl syndrome, type 5
- Bardet-Biedl syndrome, type 6
- Bardet-Biedl syndrome, type 7
- Bardet-Biedl syndrome, type 8
- Bardet-Biedl syndrome, type 9
- Bruns-Garland syndrome
- Cardiomyopathy diabetes deafness
- Christian-Demyer-Franken syndrome
- Chromosome 15q duplication syndrome
- Chromosome 15q, deletion
- Chromosome 15q, trisomy
- Chronic Pancreatitis
- DEND syndrome
- Diabetes insipidus, diabetes mellitus, optic atrophy
- Diabetes insipidus, diabetes mellitus, optic atrophy, deafness, mitochondrial form
- Diarrhea - polyendocrinopathy - infections, X-linked
- Diarrhea chronic with villous atrophy
- DIDMOAD Syndrome, Mitochondrial form
- Endocrine pancreatic cancer
- Familial isolated deficiency of vitamin E
- Feigenbaum-Bergeron-Richardson syndrome
- Functioning pancreatic endocrine tumor
- Furukawa-Takagi-Nakao syndrome
- Gastrocutaneous syndrome
- Hemochromatosis
- Hyperadrenalism
- Ichthyosis and male hypogonadism
- Ichthyosis male hypogonadism
- Insulin-resistant acanthosis nigricans, type A
- Juvenile tropical pancreatitis syndrome
- Kearns-Sayre Syndrome
- Kyrle disease
- Langerhans Cell Histiocytosis
- Lawrence-Seip syndrome
- Lipoatrophy with diabetes, hepatic steatosis, cardiomyopathy, and leukomelanodermic papules
- Lipodystrophy
- Maternally inherited diabetes and deafness
- Maternally inherited diabetes and deafness with cardiomyopathy
- Mental retardation - epileptic seizures - hypogonadism - hypogenitalism -microcephaly - obesity
- Mental retardation syndrome, Belgian type
- Mental retardation, epileptic seizures, hypogonadism and hypogenitalism, microcephaly, and obesity
- Metabolic disorders
- Neuropathy, hereditary motor and sensory, Okinawa type
- Niacin overdose
- Norrie syndrome
- Pancreatic Islet Cell Cancer
- Pancreatic islet cell tumors (functioning tumor)
- Pancreatitis
- Pheochromocytoma
- Pituitary cancer, childhood
- Pituitary tumors, adult
- POEMS syndrome
- Polycystic ovary syndrome
- Polyendocrine deficiency syndrome type 2
- Powell-Buist-Stenzel syndrome
- Premature aging, Okamoto type
- Renal tubular acidosis, distal, type 4
- Retinohepatoendocrinologic syndrome
- Short stature cranial hyperostosis hepatomegaly diabetes
- Short stature, cranial hyperostosis, hepatomegaly and diabetes
- Siderosis
- Somatostatinoma
- Thiamine responsive megaloblastic anemia syndrome
- Troell-Junet syndrome
- Van Goethem syndrome
- Wolfram Syndrome 2
- Wolfram Syndrome, Mitochondrial form
- Wolfram's disease
Medications or substances causing Diabetes:
The following drugs, medications, substances or toxins are some of the possible
causes of Diabetes as a symptom.
This list is incomplete and various other drugs or substances
may cause your symptoms.
Always advise your doctor of any medications or treatments you are using,
including prescription, over-the-counter, supplements, herbal or alternative treatments.
- Niacin (Vitamin B3) - excessive niacin can cause high blood sugars.
- Steroids - Some steroids raise blood sugars and thus mimic diabetes (usually Type 2).
- Pyriminil (Vacor) - a rat poision, can cause Type I diabetes
- Pentamidine - a pneumonia treatment, can cause Type I diabetes
- L-asparaginase - an anti-cancer drug, can cause Type I diabetes
- more drugs...»
See full list of 76 medications causing Diabetes
Drug interactions causing Diabetes:
When combined, certain drugs, medications, substances or toxins may react causing Diabetes as a symptom.
The list below is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.
- Semprex-D and over-the-counter drugs that relieve cold symptoms interaction
- Trinalin Repetabs and over-the-counter drugs that relieve cold symptoms interaction
- Brofed Liquid and over-the-counter drugs that relieve cold symptoms interaction
- Bromfed and over-the-counter drugs that relieve cold symptoms interaction
- Bromfed-PD and over-the-counter drugs that relieve cold symptoms interaction
- more interactions...»
See full list of 78 drug interactions causing Diabetes
What causes Diabetes?
Causes: Diabetes:
Either reduced insulin production or poor insulin metabolism, depending on subtype.
Article excerpts about the
causes of Diabetes:
Am I at Risk for Type 2 Diabetes: NIDDK (Excerpt)
People develop diabetes for two reasons: the pancreas does not make enough insulin for the body's needs, or the cells in the muscles, liver, and fat do not use insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, leading to complications such as blindness, heart and kidney disease, nerve problems, gum infections, and amputation. (Source: excerpt from Am I at Risk for Type 2 Diabetes: NIDDK)
Keep your kidneys healthy: NIDDK (Excerpt)
High blood sugar and high blood pressure damage the kidneys’ glomeruli. When the kidneys are damaged, the protein leaks out of the kidneys into the urine. Damaged kidneys do not do a good job of cleaning out waste and extra fluids. So not enough waste and fluids go out of the body as urine. Instead, they build up in your blood. (Source: excerpt from Keep your kidneys healthy: NIDDK)
Dealing With Diabetes - Age Page - Health Information: NIA (Excerpt)
If you have diabetes, your body cannot properly convert foods into the energy needed for daily activity. Our bodies change the foods we eat into a form of sugar called glucose. Glucose travels through the bloodstream to "fuel" or feed our cells. Sometimes it is stored in the liver for future use. Insulin is a hormone that is made in the pancreas and helps cells take in the amount of glucose they need. People with diabetes do not make or properly use insulin. As a result, glucose builds up in their blood and causes many symptoms of diabetes such as feeling tired, losing weight, feeling hungry or thirsty, urinating frequently or having vision problems (Source: excerpt from Dealing With Diabetes - Age Page - Health Information: NIA)
Medical news summaries relating to Diabetes:
The following medical news items are relevant to causes of Diabetes:
- 52 percent of British people fear exercise for one reason or another
- 70 percent of people in India may have undiagnosed diabetes
- Agent Orange's long term toll
- Alzheimer's protein affected by body fat
- Bone problems for obese kids
- Childhood obesity tripling in concern
- Children increasingly face adult diseases
- Children suffering adult disease
- Chronic pancreatitis can lead to diabetes
- Cow's milk may be the key to many of western society's health problems
- Current trends in health
- Depression may increase diabetes risk
- Diabetes and risk reduction
- Diabetes and sugar level linked to risk of cancer death
- Diabetes in children demanding education
- Diabetes linked to smoking
- Diabetes: the simple facts
- Diabetic and complications
- Diabetics are more prone to the potentially fatal bacteremia and sepsis
- Diabetics need to be aware of possible complications
- Dollars dictate diet
- Early cessation of steroid following liver transplant increases rate of rejection
- Eating disorders can greatly increase the risk of complications in people with type 1 diabetes
- Excess weight is linked to a myriad of diseases
- Fast food diet linked to diabetes risk
- Fast food linked to weight increase and diabetes
- GI diet to assist cystic ovary disease
- Heart disease established from embryonic stage
- Heart disease link to impotence
- HIV patients face increased risk of diabetes and dementia
- Improved blood sugar control with weight lifting
- Insulin resistance, a predictor of type 2 diabetes
- International research aims to determine if cow's milk increases risk of type 1 diabetes
- Liver disease is one of the biggest killers amongst diabetics
- Long-term offspring health may be affected by mother's diet during pregnancy
- Lund disease may be linked to diabetes
- Moderate drinking has protective effect against type 2 diabetes
- More to diabetes diagnosis
- New diagnostic technique for pre-diabetes
- New Dietary Guidelines support numerous research results
- New risk factors may be associated with cardiovascular disease risk
- Obesity also risk for cancer
- Obesity causing dramatic increase in diabetes
- Obesity increases risk of complications during pregnancy
- Obesity is associated with an increased risk of many conditions
- Obesity leads to liver disease
- Operation options for obesity
- Oral health and overall wellbeing
- Oral health problems more prevalent in diabetics with poor sugar level control
- Pancreatic cancer surgery less common in black men
- Plant protein may protect against some human diseases
- Premature birth increases diabetes risk
- Prevention of osteoporosis in cystic fibrosis
- Prostate cancer risk reduced in diabetics
- Red meat consumption linked to higher risk of type 2 diabetes
- Researchers discover part of brain that is partly responsible for weight control
- Risky obesity surgery
- Scientists examine effects of lack of activity
- Scientists find exercise secrets in order to develop a pill to take the place of exercise
- Similar risk factors for kidney infection and urinary tract infection
- Some antipsychotic drugs linked to increased risk of developing type 2 diabetes
- Symptoms of old age may be similar to many other treatable conditions
- Teenagers and cancer
- Therapy to reduce allergies to cats
- Uncontrolled diabetes can have serious consequences
- Vioxx tended not to be used by targeted group
- Vitamin D essential for more than just bone health
- Warning signs of a heart attack
- Weighty issue for men
- Workplace stress, sickening
- More news »
Cause statistics for Diabetes:
The following are statistics from various sources about the causes of Diabetes:
- Statistics on the underlying causes of deaths due to diabetes and diabetes-related disorders:
- Diabetes was listed as the only cause of death in 1.7% of cases in Australia, 2002 (Australia’s Health 2004, AIHW)
- 50% of deaths from diabetes also had heart disease as an associated cause of death in Australia, 2002 (Australia’s Health 2004, AIHW)
- 22% of deaths from diabetes also had stroke as an associated cause of death in Australia, 2002 (Australia’s Health 2004, AIHW)
- 15% of deaths from diabetes also had renal failure as an associated cause of death in Australia, 2002 (Australia’s Health 2004, AIHW)
- more statistics...»
Related information on causes of Diabetes:
As with all medical conditions, there may be many causal factors. Further relevant information on causes of Diabetes may be found in:
- Risk factors for Diabetes
- Medications that may cause Diabetes
- Contagiousness for Diabetes
- Genetics of Diabetes
- Hidden causes of Diabetes
Causes of Diabetes: Online Medical Books
16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Diabetes.
Hyperglycemia:
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Impaired fasting glucose
-
Medications
–Corticosteroids are a common cause
–Common medications include growth hormone, estrogen (including oral contraceptives), nicotinic acid, salicylates and NSAIDs, thiazide and loop diuretics, phenytoin, and epinephrine - Diabetes mellitus type I
–Diabetic ketoacidosis - Diabetes mellitus type II
-
Pancreatic disease
–Acute or chronic pancreatitis
–Pancreatectomy
–Pancreatic carcinoma
–Hemochromatosis
–Cystic fibrosis -
Increased counter-regulatory hormones associated with acute disease
–Myocardial infarction
–Stroke or other neurologic disease
–Renal insufficiency
–Hepatic insufficiency - Acromegaly
- Cushing's syndrome
- Pheochromocytoma
- Hyperthyroidism (thyroid storm)
- Glucagonoma
- Gestational diabetes
- Amyloidosis
Source: In a Page: Signs and Symptoms, 2004
Hyperglycemia:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
- Type I diabetes mellitus
–Most common form of diabetes in children
–Prevalence: 1.9/1,000
–Autoimmune-mediated destruction of pancreatic islets (β-cells)
–Absolute insulin deficiency
–Often presents with ketosis and DKA
- Type II diabetes mellitus
–Increasing prevalence in children, especially among obese
–In children, onset usually in mid-puberty
–More frequent in blacks, Hispanics, Pacific Islanders, Asians, and Native Americans (Pima Indians)
–Strong association with family history of type II diabetes
–Insulin resistance and inadequate insulin secretion results in relative insulin deficiency
-
Maturity-onset diabetes of the young (MODY)
–Infrequent
–Autosomal dominant disease
–Onset usually between 9 and 25 years old
–Genetic defects in enzymes or nuclear transcription factors involved in islet cell development or the regulation of insulin secretion -
Drug- or chemical-induced diabetes
–Glucocorticoids, β-adrenergic agonists, phenytoin, asparaginase, cyclosporine, tacrolimus, vacor, pentamidine, diazoxide, nicotinic acid, thyroid hormone, thiazides - Other endocrinopathies: Cushing disease, acromegaly, pheochromocytoma
-
Exocrine pancreatic diseases
–Cystic fibrosis
–Hemochromatosis - Pancreatectomy
- Physiological stress (trauma, infection)
-
Infections
–CMV
–Congenital rubella - Genetic syndromes: Prader-Willi syndrome, Down syndrome, Turner syndrome, Klinefelter syndrome, Wolfram syndrome
Source: In A Page: Pediatric Signs and Symptoms, 2007
Polydipsia:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
-
Diabetes mellitus (type I and type II)
–Hyperglycemia drives an osmotic diuresis that causes polyuria, which then leads to dehydration, increased thirst, and polydipsia -
Diabetes insipidus
–Abnormal water balance due to vasopressin (ADH) deficiency or resistance, causing excretion of large amounts of dilute urine -
Central or neurogenic diabetes insipidus
(vasopressin deficiency)
–Congenital
–Familial (autosomal dominant)
–Acquired: Neurosurgery, tumor (e.g., craniopharyngioma), head trauma, infiltrative/inflammatory, infectious-
Nephrogenic diabetes insipidus (decreased responsiveness of the kidneys to vasopressin)
–Familial (X-linked dominant and recessive forms)
–Acquired: Renal disease, obstructive uropathy, hypercalcemia/hypercalciuria
–Hypokalemia, drug-induced (e.g., lithium, diuretics, ethanol, cisplatin)
–Gestational DI: Increased clearance of ADH by placental vasopressinase, lower osmolar threshold for thirst and ADH release -
Primary polydipsia
–Compulsive water drinking
–Dipsogenic DI - Primary hyperaldosteronism
- Diabetes insipidus, diabetes mellitus, optic atrophy, and deafness (DIDMOAD) syndrome
- Bartter syndrome
- Hypertension (e.g., pheochomocytoma)
- Neuroblastoma
- Cystinosis
- Congestive heart failure
-
Nephrogenic diabetes insipidus (decreased responsiveness of the kidneys to vasopressin)
Source: In A Page: Pediatric Signs and Symptoms, 2007
Polydipsia:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Diabetes insipidus
Diabetes insipidus characteristically produces polydipsia and may also cause excessive voiding of dilute urine and mild to moderate nocturia. Fatigue and signs of dehydration occur in severe cases.
Diabetes mellitus
Polydipsia is a classic finding with diabetes mellitus — a consequence of the hyperosmolar state. Other characteristic findings include polyuria, polyphagia, nocturia, weakness, fatigue, and weight loss. Signs of dehydration may occur.
Hypercalcemia
As hypercalcemia progresses, the patient develops polydipsia, polyuria, nocturia, constipation, paresthesia and, occasionally, hematuria and pyuria. Severe hypercalcemia can progress quickly to vomiting, a decreased level of consciousness, and renal failure. Depression, mental lassitude, and increased sleep requirements are common.
Hypokalemia
Hypokalemia is an electrolyte imbalance that can cause nephropathy, resulting in polydipsia, polyuria, and nocturia. Related hypokalemic signs and symptoms include muscle weakness or paralysis, fatigue, decreased bowel sounds, hypoactive deep tendon reflexes, and arrhythmias.
Psychogenic polydipsia
Psychogenic polydipsia is an uncommon disorder that causes polydipsia and polyuria. It may occur with any psychiatric disorder, but is more common with schizophrenia. Signs of psychiatric disturbances, such as anxiety or depression, are typical. Other findings include a headache, blurred vision, weight gain, edema, elevated blood pressure and, occasionally, stupor and coma. Signs of heart failure may develop with overhydration.
Renal disorders (chronic)
Chronic renal disorders, such as glomerulonephritis and pyelonephritis, damage the kidneys, causing polydipsia and polyuria. Associated signs and symptoms include nocturia, weakness, elevated blood pressure, pallor and, in later stages, oliguria.
Sheehan’s syndrome
Polydipsia, polyuria, and nocturia occur with Sheehan’s syndrome, a disorder of postpartum pituitary necrosis. Other features include fatigue, failure to lactate, amenorrhea, decreased pubic and axillary hair growth, and a reduced libido.
Sickle cell anemia
As nephropathy develops, polydipsia and polyuria occur. They may be accompanied by abdominal pain and cramps, arthralgia and, occasionally, lower extremity skin ulcers and bone deformities, such as kyphosis and scoliosis.
Other causes
Drugs
Diuretics and demeclocycline may produce polydipsia. Phenothiazines and anticholinergics can cause dry mouth, making the patient so thirsty that he drinks compulsively.
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Diabetic complications during pregnancy:
Causes
(Professional Guide to Diseases (Eighth Edition))
In diabetes mellitus, glucose is inadequately utilized either because insulin isn’t synthesized or because tissues are resistant to the hormonal action of endogenous insulin. During pregnancy, the fetus relies on maternal glucose as a primary fuel source. Pregnancy triggers protective mechanisms that have anti-insulin effects: increased hormone production (placental lactogen, estrogen, and progesterone), which antagonizes insulin’s effects; degradation of insulin by the placenta; and prolonged elevation of stress hormones (cortisol, epinephrine, and glucagon), which raise blood glucose levels.
In a normal pregnancy, an increase in anti-insulin factors is counterbalanced by an increase in insulin production to maintain normal blood glucose levels. However, females who are prediabetic or diabetic are unable to produce sufficient insulin to overcome the insulin antagonist mechanisms of pregnancy, or their tissues are insulin-resistant. As insulin requirements rise toward term, the patient who’s prediabetic may develop gestational diabetes, necessitating dietary management and, possibly, exogenous insulin to achieve glycemic control, whereas the patient who’s insulin-dependent may need increased insulin dosage.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hereditary fructose intolerance:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Transmitted as an autosomal recessive trait, hereditary fructose intolerance results from a deficiency in the enzyme fructose-1-phosphate aldolase. The enzyme operates at only 1% to 10% of its normal biological activity, thus preventing rapid uptake of fructose by the liver after ingestion of fruit or foods containing cane sugar.
In some European countries, hereditary fructose intolerance may have an incidence as high as 1 in 20,000 people.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetes mellitus:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
DM affects an estimated 6% of the population of the United States, about half of whom are undiagnosed. Incidence is greater in females and rises with age. Type 2 accounts for 90% of cases.
In type 1 diabetes, pancreatic beta-cell destruction or a primary defect in beta-cell function results in failure to release insulin and ineffective glucose transport. Type 1 immune-mediated diabetes is caused by cell-mediated destruction of pancreatic beta cells. The rate of beta-cell destruction is usually higher in children than in adults. The idiopathic form of type 1 diabetes has no known cause. Patients with this form have no evidence of autoimmunity and don’t produce insulin.
In type 2 diabetes, beta cells release insulin, but receptors are insulin-resistant and glucose transport is variable and ineffective. Risk factors for type 2 diabetes include:
❑ obesity (even an increased percentage of body fat primarily in the abdominal region); risk decreases with weight and drug therapy
❑ lack of physical activity
❑ history of GDM
❑ hypertension
❑ Black, Hispanic, Pacific Islander, Asian American, Native American origin
❑ strong family history of diabetes
❑ older than age 45
❑ high-density lipoprotein cholesterol of less than 35 or triglyceride of greater than 250
❑ Seriously impaired glucose tolerance (IGT) test.
The “other specific types” of DM result from various conditions (such as a genetic defect of the beta cells or endocrinopathies) or from use of or exposure to certain drugs or chemicals. GDM is considered present whenever a patient has any degree of abnormal glucose during pregnancy. This form may result from weight gain and increased levels of estrogen and placental hormones, which antagonize insulin.
Insulin transports glucose into the cell for use as energy and storage as glycogen. It also stimulates protein synthesis and free fatty acid storage in the fat deposits. Insulin deficiency compromises the body tissues’access to essential nutrients for fuel and storage.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetes insipidus results centrally from intracranial neoplastic or metastatic lesions, hypophysectomy or other neurosurgery, a skull fracture, or head trauma that damages the neurohypophyseal structures. It can also result nephrogenically from infection, granulomatous disease, and vascular lesions; it may be idiopathic and, rarely, familial. (Note: Pituitary diabetes insipidus shouldn’t be confused with nephrogenic diabetes insipidus, a rare congenital disturbance of water metabolism that results from renal tubular resistance to vasopressin.)
Normally, the hypothalamus synthesizes vasopressin. The posterior pituitary gland (or neurohypophysis) stores vasopressin and releases it into general circulation, where it causes the kidneys to reabsorb water by making the distal tubules and collecting duct cells water-permeable. The absence of vasopressin in diabetes insipidus allows the filtered water to be excreted in the urine instead of being reabsorbed.
Nephrogenic diabetes insipidus involves a defect in the parts of the kidneys that reabsorb water back into the bloodstream. It occurs less commonly than central diabetes insipidus. Nephrogenic diabetes insipidus may occur as an inherited disorder in which male children receive the abnormal gene that causes the disease on the X chromosome from their mothers. Nephrogenic diabetes insipidus may also be caused by diseases of the kidney (such as polycystic kidney disease) and the effects of certain drugs (such as lithium and amphotericin B).
Diabetes insipidus is rare, affecting 1 in 25,000 people. Males and females are affected equally.
Source: Professional Guide to Diseases (Eighth Edition), 2005
This disorder characteristically produces polydipsia and may also cause excessive voiding of dilute urine and mild to moderate nocturia. Fatigue and signs of dehydration occur in severe cases.
Polydipsia is a classic finding with this disorder—a consequence of the hyperosmolar state. Other characteristic findings include polyuria, polyphagia, nocturia, weakness, fatigue, and weight loss. Signs of dehydration may occur.
As this disorder progresses, the patient develops polydipsia, polyuria, nocturia, constipation, paresthesia and, occasionally, hematuria and pyuria. Severe hypercalcemia can progress quickly to vomiting, decreased level of consciousness, and renal failure. Depression, mental lassitude, and increased sleep requirements are common.
This electrolyte imbalance can cause nephropathy, resulting in polydipsia, polyuria, and nocturia. Related hypokalemic signs and symptoms include muscle weakness or paralysis, fatigue, decreased bowel sounds, hypoactive deep tendon reflexes, and arrhythmias.
This uncommon disorder causes polydipsia and polyuria. This condition may occur with any psychiatric disorder, but more common with schizophrenia. Signs of psychiatric disturbances, such as anxiety or depression, are typical. Other findings include headache, blurred vision, weight gain, edema, elevated blood pressure and, occasionally, stupor and coma. Signs of heart failure may develop with overhydration.
Chronic renal disorders, such as glomerulonephritis and pyelonephritis, damage the kidneys, causing polydipsia and polyuria. Associated signs and symptoms include nocturia, weakness, elevated blood pressure, pallor and, in later stages, oliguria.
Polydipsia, polyuria, and nocturia occur within this syndrome of postpartum pituitary necrosis. Other features include fatigue, failure to lactate, amenorrhea, decreased pubic and axillary hair growth, and reduced libido.
As nephropathy develops, polydipsia and polyuria occur. They may be accompanied by abdominal pain and cramps, arthralgia and, occasionally, lower extremity skin ulcers, and bone deformities, such as kyphosis and scoliosis.
This disorder infrequently causes polydipsia. Characteristic findings include tachycardia, palpitations, weight loss despite increased appetite, diarrhea, tremors, an enlarged thyroid, dyspnea, nervousness, diaphoresis, and heat intolerance. Exophthalmos may also occur.
Diuretics and demeclocycline may produce polydipsia. Phenothiazines and anticholinergics can cause dry mouth, making the patient so thirsty that he drinks compulsively.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
In diabetes mellitus, glucose is inadequately used either because insulin isn’t synthesized (as in type 1, insulin-dependent diabetes) or because tissues are resistant to the hormonal action of endogenous insulin (as in type 2, non–insulin-dependent diabetes).
During pregnancy, the fetus relies on maternal glucose as a primary fuel source. Pregnancy triggers protective mechanisms that have anti-insulin effects: increased hormone production (placental lactogen, estrogen, and progesterone), which antagonizes the effects of insulin; degradation of insulin by the placenta; and prolonged elevation of stress hormones (cortisol, epinephrine, and glucagon), which raise blood glucose levels.
In a normal pregnancy, an increase in anti-insulin factors is counterbalanced by an increase in insulin production to maintain normal blood glucose levels. However, women who are prediabetic or diabetic can’t produce sufficient insulin to overcome the insulin antagonist mechanisms of pregnancy, or their tissues are insulin-resistant.
As insulin requirements rise toward term, the patient who is prediabetic may develop gestational diabetes, necessitating dietary management and, possibly, exogenous insulin to achieve glycemic control. The insulin-dependent patient may need increased insulin dosage.
Source: Handbook of Diseases, 2003
The effects of diabetes mellitus result from insulin deficiency. Insulin transports glucose into the cell for use as energy and storage as glycogen. It also stimulates protein synthesis and free fatty acid storage. Insulin deficiency or resistance compromises the body tissues’access to essential nutrients for fuel and storage.
Type 1A results from autoimmune beta-cell destruction, resulting in insulin deficiency. Type 1B leaves these immunologic markers but results in insulin deficiency and kerosis.
Other risk factors include the following:
❑ Obesity contributes to the resistance to endogenous insulin.
❑ Physiologic or emotional stress can cause prolonged elevation of stress hormone levels (cortisol, epinephrine, glucagon, and growth hormone). This raises blood glucose levels, which, in turn, places increased demands on the pancreas.
❑ Pregnancy causes weight gain and increases levels of estrogen and placental hormones, which antagonize insulin.
❑ Some medications can antagonize the effects of insulin, including thiazide diuretics, adrenal corticosteroids, and hormonal contraceptives.
Source: Handbook of Diseases, 2003
Pituitary diabetes insipidus results from intracranial neoplastic or metastatic lesions, hypophysectomy or other neurosurgery, a skull fracture, or head trauma that damages the neurohypophyseal structures. It can also result from infection, granulomatous disease, and vascular lesions; it may be idiopathic and, rarely, familial.
The hypothalamus synthesizes vasopressin. The posterior pituitary gland (or neurohypophysis) stores vasopressin and releases it into the general circulation, where it causes the kidneys to reabsorb water by making the distal tubules and collecting duct cells water-permeable.
In pituitary diabetes insipidus, the absence of vasopressin allows the filtered water to be excreted in the urine instead of being reabsorbed. In renal diabetes insipidus, the kidney doesn’t respond to vasopressin, which is usually present in high concentrations.
Source: Handbook of Diseases, 2003
Diabetes insipidus characteristically produces polydipsia and may also cause excessive voiding of dilute urine and mild to moderate nocturia. Fatigue and signs of dehydration occur in severe cases.
Polydipsia is a classic finding with diabetes mellitus — a consequence of the hyperosmolar state. Other characteristic findings include polyuria, polyphagia, nocturia, weakness, fatigue, and weight loss. Signs of dehydration may occur. (See Associated disorder: Diabetes mellitus, page 514.)
CULTURAL CUE:Diabetes is the fourth leading cause of death in Black, Native American, Hawaiian, and Filipino women. Also, Blacks are at greater risk for developing diabetes than Whites.
As hypercalcemia progresses, the patient develops polydipsia, polyuria, nocturia, constipation, paresthesia and, occasionally, hematuria and pyuria. Severe hypercalcemia can progress quickly to vomiting, decreased level of consciousness, and renal failure. Depression, mental lassitude, and increased sleep requirements are common.
An electrolyte imbalance — hypokalemia — can cause nephropathy, resulting in polydipsia, polyuria, and nocturia. Related hypokalemic signs and symptoms include muscle weakness or paralysis, fatigue, decreased bowel sounds, hypoactive deep tendon reflexes, and arrhythmias.
Chronic renal disorders, such as glomerulonephritis and pyelonephritis, damage the kidneys, causing polydipsia and polyuria. Associated signs and symptoms include nocturia, weakness, elevated blood pressure, pallor and, in later stages, oliguria.
As nephropathy develops in patients with sickle cell anemia, polydipsia and polyuria occur. They may be accompanied by abdominal pain and cramps, arthralgia and, occasionally, lower extremity skin ulcers and such bone deformities as kyphosis and scoliosis.
Diuretics and demeclocycline may produce polydipsia. Phenothiazines and anticholinergics can cause dry mouth, making the patient so thirsty that he drinks compulsively.
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Diabetes insipidus.Diabetes insipidus characteristically produces polydipsia and may also cause excessive voiding of dilute urine and mild to moderate nocturia. Fatigue and signs of dehydration occur in severe cases.
Diabetes mellitus.Polydipsia is a classic finding with diabetes mellitus—a consequence of the hyperosmolar state. Other characteristic findings include polyuria, polyphagia, nocturia, weakness, fatigue, and weight loss. Signs of dehydration may occur.
Hypercalcemia.As hypercalcemia progresses, the patient develops polydipsia, polyuria, nocturia, constipation, paresthesia and, occasionally, hematuria and pyuria. Severe hypercalcemia can progress quickly to vomiting, decreased level of consciousness, and renal failure. Depression, mental lassitude, and increased sleep requirements are common.
Hypokalemia.Hypokalemia can cause polydipsia, polyuria, and nocturia. Related hypokalemic signs and symptoms include muscle weakness or paralysis, fatigue, decreased bowel sounds, hypoactive deep tendon reflexes, and arrhythmias.
Psychogenic polydipsia.Psychogenic polydipsia causes polydipsia and polyuria. It may occur with any psychiatric disorder, but is more common with schizophrenia. Signs of psychiatric disturbances, such as anxiety or depression, are typical. Other findings include headache, blurred vision, weight gain, edema, elevated blood pressure and, occasionally, stupor and coma. Signs of heart failure may develop with overhydration.
Renal disorders (chronic).Chronic renal disorders, such as glomerulonephritis and pyelonephritis, damage the kidneys, causing polydipsia and polyuria. Associated signs and symptoms include nocturia, weakness, elevated blood pressure, pallor and, in later stages, oliguria.
Sheehan's syndrome.Polydipsia, polyuria, and nocturia occur with Sheehan's syndrome, a disorder of postpartum pituitary necrosis. Other features include fatigue, failure to lactate, amenorrhea, decreased pubic and axillary hair growth, and a reduced libido.
Sickle cell anemia.With sickle cell anemia, as nephropathy develops, polydipsia and polyuria occur. They may be accompanied by abdominal pain and cramps, arthralgia and, occasionally, lower extremity skin ulcers and bone deformities, such as kyphosis and scoliosis.
Drugs.Diuretics and demeclocycline may produce polydipsia. Phenothiazines and anticholinergics can cause dry mouth, making the patient so thirsty that he drinks compulsively.
Source: Nursing: Interpreting Signs and Symptoms, 2007
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Medical Articles:
Diabetes insipidus:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Polydipsia:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Diabetes insipidus
Diabetes mellitus
Hypercalcemia
Hypokalemia
Psychogenic polydipsia
Renal disorders (chronic)
Sheehan’s syndrome
Sickle cell anemia
Thyrotoxicosis
Other causes
Drugs
Diabetic complications during pregnancy:
Causes
(Handbook of Diseases)
Protective mechanisms
Diabetes mellitus:
Causes
(Handbook of Diseases)
Diabetes insipidus:
Causes
(Handbook of Diseases)
Polydipsia:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Diabetes insipidus
Diabetes mellitus
Hypercalcemia
Hypokalemia
Renal disorders (chronic)
Sickle cell anemia
Other causes
Drugs
Polyuria and Polydipsia:
Principal Causes of Polyuria and Polydipsia
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
Polydipsia:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Other causes
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