Vasopressin antidiuretic hormone is synthesized in suprasoptic and paravementricular hypothalamus nuclei. By contacting the neurophysine protein, the ADG-neurophysine complex in the form of granules is transported to the terminal expansions of axons of the neurohypophysis and the median elevation. In contact with the capillary endings of axons, ADG accumulation takes place. The secretion of ADG depends on the osmolality of the plasma, circulating blood volume and blood pressure. On changes electrolyte composition The blood reacts with osmotically sensitive cells located in the arrogal departments of the front hypothalamus. Increased activity of Osselicceptors When increasing blood osmolality stimulates vasopressine neurons, from the endings of which vasopressin is released into the overall blood flow. In physiological conditions, plasma osmolability is within 282-300 mos / kg. Normally, the threshold for secretion of ADG is the osmolability of blood plasma starting with 280 mos / kg. Lower values \u200b\u200bfor the secretion of ADG may be observed during pregnancy, acute psychosis, oncological diseases. The decrease in plasma osmolality caused by the reception of a large amount of fluid suppresses the adg secretion. At the level of plasma osmolality, more than 295 moss / kg are noted increasing the secretion of ADG and the activation of the thirst center (Fig. 1). Controlled by Ossetletems of Vascular Plexction of the front of the hypothalamus Activated center of thirst and ADG prevents the body dehydration.

Regulation of the secretion of vasopressin depends on changes in blood volume. When bleeding, the voltoreceptors located in the left atrium are significant effect on the secretion of vasopressin. In the blood pressure vessels acts through the V1-Barosorriceceptors, which are located on the smooth muscle cells of the vessels. Vasoconstrictor action of vasopressin with blood loss is due to a reduction in the smooth muscle layer of the vessel, which prevents the drop of blood pressure. When decreasing blood pressure, more than 40% there is an increase in the level of ADG, 100 times the value of its basal concentration. Baroreceptors located in the carotid sine and the aorta arc are reacting to the increase of blood pressure, which ultimately leads to a decrease in the adg secretion. In addition, ADG participates in the regulation of hemostasis, the synthesis of prostaglandins, contributes to the release of renin.

Sodium and mannitol ions are powerful vasopressin secretion stimulants. The urea does not affect the secretion of the hormone, and glucose leads to the braking of its secretion.

Antidiuretic hormone action mechanism

ADG is the most important regulator of water delay and provides homeostasis of fluid together with atrial sodium-system hormone, aldosterone and angiotensin II.

The main physiological effect of vasopressin is to stimulate the reabsorption of water in the collective channels of the cortical and brain layer of the kidneys against the osmotic gradient of the pressure.

In the cells of the renal tubules, ADG acts through the V2-baroreceptors (type 2 vasopressic receptors), which are located on basolateral collective tubular cell membranes. The interaction of ADG with V2 receptors leads to the activation of vasopressinching adenylate cyclase and an increase in production of cyclic adenosine monophosphate (AMP). The cyclic AMP activates proteinkinase, and, which in turn stimulates the embedding of proteins of water channels, Aquaporin-2 to the apical membrane of cells. This provides water transport from the lumen of collective tubes to the cage and further: through the water channels of Aquaporin-3 and Aquaporin-4 located on the basolateral membrane and water, 4 water is transported to the intercellular space, and then blood vessels. As a result, a concentrated urine with high osmolallity is formed (Fig. 2).

Osmotic concentration is the total concentration of all dissolved particles. It can be interpreted as osmolarity and measured in osmole / l or as osmolanity - in osmole / kg. The difference between osmolarity and osmolality is a method for producing this value. For osmolarity, this is a calculated method for the concentration of basic electrolytes in the measured fluid. Osmolarity calculation formula:

Osmolarity \u003d 2 x (na (mmol / l) + K (mmol / l)) + glucose (mmol / l) + urea (mmol / l) + 0.03 x Total protein (g / l).

Plasma Opelness, urine and other biological fluids are osmotic pressure, depending on the number of ions, glucose and urea, which is determined using the osmometer instrument. Osmolation is less osmolarity on the value of oncotic pressure.

With normal secretion of ADG, urine osmolarity is always higher than 300 mosm / l and can even increase to 1200 mos / l and higher. With ADG deficiency, urine osmolarity is below 200 mosm / l.

Etiological factors of central unacceptable diabetes

Among the primary reasons for the development of the CND, the hereditary family shape of the disease transmitted by autosomal-dominant or autosomal-recessive type of inheritance is distinguished. The presence of a disease can be traced in several generations and can affect a number of family members, it is due to mutations leading to changes in the structure of ADG (Didmoad-syndrome). Congenital anatomical defects in the development of medium and intermediate brain can also be the primary causes of the development of the CND. In 50-60% of cases primary cause CND cannot be installed - this is the so-called idiopathic not diabetes.

Among the secondary reasons leading to the development of the CND, they call the crank-brain injury (concussing the brain, the eye injury, the fracture of the skull base).

The development of the secondary NSD can be associated with states after transcranial or transphenoidal operations on the pituitary gland about such brain tumors, like craniopharyagoma, pinealoma, Hermic, leading to the compression and atrophy of the rear lobe of the pituitary.

Inflammatory changes in the hypothalamus, suprasopticspofizar tract, funnels, legs, the rear lobe of the pituitary secondary reasons CND development.

The leading factor in the occurrence of the organic form of the disease is infection. Among sharp infectious diseases Highlight flu, encephalitis, meningitis, angina, scarletin, pertussis; Among chronic infectious diseases - tuberculosis, brucellosis, syphilis, malaria, rheumatism.

Among vascular reasons CNDs can be called Schiena syndrome, violations of blood supply to neurohypophysis, thrombosis, aneurysm.

Depending on the anatomical Localization of the CND, it can be permanent or transient. In case of damage to the suprasoptic and paraventricular nuclei, the ADG function is not restored.

The development of nephrodic ND is based on congenital receptor or enzymatic disorders of the distal kidney channels, leading to the receptor resistance to the action of ADG. In this case, the content of endogenous ADG may be normal or elevated, and the admission of ADG does not eliminate the symptoms of the disease. Nephrogenic ND may occur with long-term chronic infections. urinary tract, urolithiasis (ICD), prostate adenoma.

Symptomatic nephlogenous ND can develop for diseases accompanied by damage to the distal kidney channels, such as sickle cell anemia, sarcoidosis, amyloidosis. In hypercalcemia conditions, the sensitivity to ADG is reduced and the water reabsorption decreases.

Psychogenic polydipsia develops on nervous soil predominantly in women of menopausal age (Table 1). The primary appearance thirst is due functional disorders In the center of thirst. Under the influence of a large amount of fluid and increasing the volume of circulating plasma through a baroreceptor mechanism, a decreased adg secretion occurs. Investigation of urine in wintering in these patients reveals a decrease in relative density, while sodium concentration and blood osmolarity remains normal or reduced. When restricting the use of fluid, the well-being of patients remains satisfactory, while the amount of urine decreases, and its osmolarity increases to physiological limits.

Clinical picture of central unacceptable diabetes

For ND manifestation, a decrease in the secretory ability of neurohypophysis by 85% is necessary.

The main symptoms of ND are abundant urination and severe thirst. Often the volume of urine exceeds 5 liters, may even reach 8-10 liters per day.

Blood plasma hyperosmolarness stimulates the thirst center. The patient cannot do without a fluid intake for more than 30 minutes. The amount of drilled liquid when easy form Diseases usually reaches 3-5 liters, with moderate severity - 5-8 liters, with severe form - 10 liters and more. Urine is discharged, its relative density is 1000-1003 g / l. In the conditions of excessive use of fluid in patients, the appetite decreases, the gastric relent of the stomach occurs, the gastrointestinal secretion is reduced, the motorcycle gastrointestant slows down, constipation develops. Under the defeat of the hypothalamic region, with an inflammatory or traumatic process, along with ND, other disorders may also be observed, such as obesity, growth pathology, galathery, hypothyroidism, diabetes mellitus (SD). In progression of the disease, dehydration leads to dryness of the skin and mucous membranes, decrease in saliva and sweating, the development of stomatitis and naphorriage. With sharp dehydration begin to increase total weakness, heartbeat, there is a decrease in blood pressure, heavily enhances headache, nausea appears. Patients become irritable, there may be hallucinations, cramps, collaptic states.

Diagnosis of Central Nonachar Diabetes

To confirm the diagnosis at the first stage of the survey, the most frequent reasons nephrogenous ND (diabetes mellitus, hypercalcemia, hypokalemia, inflammatory kidney diseases). When the plasma hyperosmolarity is detected (more than 3000 mos / kg), hypernatremia and urine hyposmolarity (100-200 mos / kg) go to the second phase of the survey.

At this stage of the survey, a trial with dehydration (sample with the drying) is carried out to eliminate the primary polydipsy and a test with desmopressin to eliminate the nephrodic ND.

The classic trial with the drying is to prohibit the use of any liquid for 6-14 hours before and during the test (every 1-2 hours), the body weight, blood pressure, is measured, the blood plasma osmolation is determined, the sodium content in the blood plasma, volume and urine osmolability. The sample with the drying ceases when the patient loses the body mass of more than 5%, unbearable thirst, the increase in sodium content and increasing blood osmolality above the boundaries of the norm. If during the sample the osmolayality of blood\u003e 300 mos / kg, sodium level\u003e 145 mmol / l, with urine osmolability<300 мОсм/кг, для дальнейшей дифференциальной диагностики центрального и нефрогенного НД проводят тест с десмопрессином. Для этого пациент принимает 10 мкг или 0,1 мг десмопрессина или п/к, в/м или в/в вводится эквивалентная доза, равная 2 мкг десмопрессина. Пациенту разрешается выпить жидкости, по объему не превышающей 1, 5-кратный объем выделенной мочи во время пробы с сухоедением. Через 2 и 4 ч собирается моча для определения объема и осмоляльности.

If, after the administration of the desmopressin, the level of urine osmolality increases by more than 50%, the central form of ND is diagnosed. If the effect of the administered drug is less than 50% or absent, this indicates the nephrogenous form of ND.

Difficulties in the diagnosis are partial forms of CND, nephrodic ND, primary polydipsy, because in these cases there is no bright clinical picture. After the sample with the drying, the osmolalihood of urine in these patients is determined in the range from 300 to 750 mos / kg, after receiving the desmopressin, urine osmolability is<750 мОсм/кг. Дальнейшее обследование пациентов на фоне приема низких доз десмопрессина (10 мкг х 1-2 р./сут, 0,1 мг х 1-2 р./сут) в течение 7 дней включает определение суточного диуреза, осмоляльности крови и мочи. У пациентов с первичной полидипсией на фоне приема препаратов десмопрессина общее самочувствие не улучшается.

Patients with a confirmed diagnosis of the CND are carried out magnetically resonant tomography of the brain to establish the cause of the disease and identify pathological changes in the hypothalamic-pituitary area.

Treatment

CND replacement therapy is carried out by a synthetic analogue of ADG - desmopressin. The features of the chemical structure of the desmopressin are to substitute L-arginine in the 8th position of the D-arginine chain, as well as additional disaming of cysteine \u200b\u200bin the 1st position. The drug acts only on the V2 receptors of the renal tubules and does not act on the V1 receptors of the smooth muscles of blood vessels. In this regard, against the background of taking the drug, a minimum vasoconstrictor activity and a more pronounced and prolonged antidiuretic effect are noted.

Among the dosage forms of desmopressin is distinguished: a tableted oral shape, a tableted sublingual shape and intranasal spray (Table 2). Under the CND, the average therapeutic doses of tableted desmopressin vary from 0.1 mg to 1.6 mg / day, the multiplicity of reception is 2-3 rubles / day. When using a tableted sub-band shape, the initial dose of the drug is 60 μg 2-3 r. / Day, the average daily - from 60 to 360 mg / day. In the intranasal administration of the drug, the daily dose - from 10 μg to 40 μg / day, due to individual sensitivity to the drug; Multiplicity of reception - 2 r. / day.

When taking a tableted form, an antidieretic effect is observed after 1-2 hours. Intranasal administration provides a faster start of action after 15-30 minutes, since the introduction of the drug is not related to the meal of food, which provides greater bioavailability. Also, a quick therapeutic effect is noted when applying the sublingual form of the drug, the beginning of which is 15-45 minutes after reception. The interval between the drug intake and food intake is 5-10 minutes.

It should be borne in mind that food intake reduces the absorption of the drug and its effectiveness, therefore it is recommended to accept the tableted form of the drug on an empty stomach 30-40 minutes before eating or 2 hours after it. The intranasal spray can be applied regardless of food intake in patients with various gastrointestinal diseases in patients under resuscitation compounds. At the same time, catarrhal phenomena in patients make it difficult to treat this form of desmopressin. The attachment form of the drug is practically not related to meals, easily titrated. This form of desmopressin allows you to more accurately select the necessary dose of the drug.

When replacing or during the transition from one form, the desmopressin to another produce recalculation of the received dose (Table 3).

Conclusion

Currently, various forms of desmopressin are used to effectively treat patients with CNDs. Only the individual selection of the drug and the titration of its dose makes it possible to achieve clinical and laboratory compensation for the disease.

Literature

1. John F. Lakek, Peter G. Wece. Basics of endocrinology. M.: Medicine, 2000.
2. Dzeranova L.K., Pigarova E. A. Minin in the treatment of non-soldering diabetes // RMH. 2005.
3. T. 13. No. 28. C.1961-1965.
4. Kochergin I. I. Nonakharic diabetes: Selected lectures on endocrinology / under. ed. A. A. Ametova. M.: Medical Information Agency, 2009. P. 217-254.
5. Melnichenko G.A., Peterkova V.A., Fofanova O. V. Diagnostics and treatment of non-soldering diabetes: method. Recommendations. M., 2003.
6. Pigarova E.A., Dzeranova L.K., Rozhinskaya L. Ya. Central Nonachar Diabetes: Differential Diagnosis and Treatment: Method. Recommendations. M., 2010.
7. Ball S. G. Vasopressin and Disoders of Water Balance: The Physiology and Patophysiology // Ann. CLIN. Biochem. 2007. Vol. 44. P. 417-431.
8. Goldman M.B. et al. The Influence of Polydipsia on Water Excretion in Hyponatremic, Polydipsic, Schizophrenic Patients // J. Clin. Endocrinol. Metabol. 1996. Vol. 81 (4). P. 1465-1470.
9. GoodFriend T.L., Friedman A.L., Shenker Y. CHAPTER 133. HORMONAL REGULATION OF ELECTROLYTE AND WATER METABOLISM. Endocrinology, 5 th Edition / Ed. By de Groot L.J., Jameson J. L. Philadelphia: Saunders, 2006. Vol. 2. P. 1324-1367.
10. Laczi F. Diabetes Insipidus: Etiology, Diagnosis and Therapy // ORV. Hetil. 2002. Vol. 17.143 (46). P. 2579-2585.
11. Maghnie M. Diabetes Insipidus // HORM. RES. 2003. Vol. 59 (Suppl.). P. 142-154.
12. McKinley M.J., Jonson A. K. The Physiological Regulation of Thirst and Fluid Intake // News Physiol. SCI. 2004. Vol. 19. P. 1-6.
13. NEMERGUT E. C. Predictors of Diabetes Insipidus After Transsphenoidal Surgery A Review of 881 Patients // J. Neurrosurg. 2005. Vol. 103. P. 448-454.
14. Robertson G. L. Disorders of NeuroHypophysis. // Harrisons Principles of Internal Medicine, Edited by Braunwald E., Fauci A.S., Kasper D.L., Hauser S.L., Longo D.L., Jameson J. L. New York: Mc Graw-Hill, 2005. P. 2097-2101.
15. Robinson AG., Verbaliis J. G. Posterior Pituitary. // ch. 9 in William`s Textbook of Endocrinology, 11th Ed. - Saunders, 2000.vol. 2. P. 263-273.
16. Sheehan J.M., Sheehan J.P., Douds G.L., Page R. B. DDAVP Use in Patients undergoing Transsphenoidal Surgery for Pituitary Adenomas // Acta Neurochir. (WIEN). 2006. Vol. 148 (3). P. 287-291.
17. Vande Walle J., Stockner M., Raes A., Norgaard J. P. Desmopressin 30 Years In Clinical Use: a Safety Review // Curr. Drug. SAF. 2007. Vol. 2 (3). P. 232-238.
18. Verbalis J. G. Diabetes Insipidus // Rev. Endocr. Metab. DISORD. 2003. Vol. 4. P. 177-185.
19. Prager-Khoutorsky M., Bourque C. W. OSMOSENSATION IN VASOPRESSIN NEURONS CHANGING ACIN DENSITY TO OPTIMIZE FUNCTION // TRENDS NEURSCI. 2010. Vol. 33 (2). P. 76-83.

("Urise") - a disease that develops in case of insufficiency of antidiuretic hormone (ADG) isolating or reduced the sensitivity of the renal tissue to its action. As a result, there is a significant increase in the amount of liquid allocated from the urine, an uncomfortable feeling of thirst occurs. If the loss of fluid is compensated for not completely, the dehydration dehydration is developing - dehydration, a distinctive feature of which is a concomitant polyuria. The diagnosis of non-soldering diabetes is based on a clinical picture and determining the level of ADG in the blood. To clarify the causes of the development of non-soldering diabetes, a comprehensive examination of the patient is carried out.

MKB-10.

E23.2.

General

("Urise") - a disease that develops in case of insufficiency of antidiuretic hormone (ADG) isolating or reduced the sensitivity of the renal tissue to its action. The violation of the secretion of ADG hypotalamus (absolute deficit) or its physiological role with sufficient education (relative deficit) causes a decrease in reabsorption processes (reverse absorption) of fluid in the renal tubules and eliminating it with urine low relative density. In case of non-car diabetes, in connection with the release of a large amount of urine, the unfortunate thirst and the total dehydration of the body develops.

Nonacharic diabetes is rare endocrinopathy, develops independently of the floor and the age group of patients, more often in persons 20-40 years. In every 5th case, unacceptable diabetes develops as a complication of neurosurgical intervention.

Classification

Complications

Nonacharic diabetes is dangerous by the development of the body's dehydration, in cases where the loss of fluid with urine is adequately replenished. Dehydration is manifested by a sharp total weakness, tachycardia, vomiting, mental disorders, blood concentration, hypotension, up to a collapse, neurological disorders. Even with severe dehydration, polyuria is preserved.

Diagnosis of non-soldering diabetes

Typical cases allow to suspect unacceptable diabetes on non-fatty thirst and allocating more than 3 liters of urine per day. To assess the daily amount of urine, the Zimnitsky test is carried out. In the study of urine, its low relative density is determined (<1005), гипонатрийурию (гипоосмолярность мочи - 100-200 мосм/кг). В крови выявляются гиперосмолярность (гипернатрийемия) плазмы (> 290 MOS / kg), hypercalcemia and hypokalemia. Sugar diabetes is excluded by the determination of blood glucose on an empty stomach. Upon the central form of unsax diabetes, the low content of ADG is determined in the blood.

The results of drying test are indicative: abstaining from fluid intake for 10-12 hours. With incomparable diabetes, weight loss is loss of more than 5%, while maintaining low specific gravity and urine hyposmolarity. The causes of non-soldering diabetes are clarified when conducting x-ray, psycho-neurological, ophthalmologic studies. The volume formation of the brain is excluded by the conduct of MRI brain. For the diagnosis of the renal form of non-soldering diabetes, the ultrasound and KT kidney are carried out. Nephrologist is needed. Sometimes kidney biopsy is required for the differentiation of renal pathology.

Treatment of unacceptable diabetes

Treatment of symptomatic unacceptable diabetes is starting with reasons (for example, tumors). With all forms of non-active diabetes, replacement therapy is prescribed by the synthetic analogue of the ADG - desmopressin. The drug is used inside or intranasally (by instilcing into the nose). A prolonged drug from the oily solution of pituitrine is also prescribed. In the central form of non-active diabetes, chlorpropamide, carbamazepine, stimulating the secretion of antidiuretic hormone, are prescribed.

A water-salt balance is performed by infusion administration of saline solutions in large volumes. Miscellaneous diuresis during non-soldering diabetes sulfonamide diuretics (hypochlorothiazide). Nutrition for non-car diabetes is based on protein restriction (to reduce the burden on the kidneys) and sufficient consumption of carbohydrates and fats, frequent meal, increasing the number of vegetable and fruit dishes. From drinks thickening thirst recommended juices, plates, compotes.

Forecast

Incoming diabetes, developing in the postoperative period or during pregnancy, more often wears transient (transit) character, idiopathic - on the contrary, resistant. With the appropriate treatment of the danger to life, although recovery is rarely fixed.

The recovery of patients is observed in cases of successful removal of tumors, the specific treatment of unacceptable diabetes of tuberculosis, malaric, syphilitic genesis. With the right assignment of replacement hormone therapy, workability is often preserved. The least favorably the course of the nephronous form of non-soldering diabetes in children.

This is a rare endocrine disease. It is very serious and is associated with a lack of blood vasopressin hormone. This hormone performs protective functions, the composition of sodium in the blood and fluid in the body is stabilized. If the level of vasopressin begins to decline, signs of the disease immediately appear.

Symptoms of unsax diabetes

The main clinical symptoms of the disease - polyuria and polydipsy (excessive thirst).

One of the first symptoms of non-soldering diabetes is frequent urination. Up to 5 liters of urine can be excreted per day, and not having a characteristic odor and transparent. The patient appears dryness of the mucous membrane, as well as the skin.

The weight is sharply reduced, thirst torments.

The patient complains of headache, dizziness. Nausea may occur, vomiting. This disease is a consequence of the defeat of some brain departments arising from injury, in the occurrence of tumor neoplasms, as well as infections.

Nonachar diabetes armared, most often with hereditary predisposition to this disease. The heirs of the patient should be remembered about this and take all prevention measures.

The main symptoms that are manifested with non-car diabetes can be attributed as follows:

• abundant urination (up to 3-15 l urine per day);
• the main volume of urination falls at night;
• thirst and increasing fluid consumption;
• dry skin, nausea and vomiting, convulsions;
• mental disorders (insomnia, emotional lability, reduced mental activity).

Even if the patient is to limit urine in the use of liquid, it will still be allocated in large quantities, which will lead to a general dehydration of the body.

In addition to general signs, there are a number of individual symptoms that occur in patients of various floors and age:

Causes of unacceptable diabetes in women

Causes depend on the type of disease in women. In the first type they are:

• tumor in the hypothalamus;
• complications after operations on the brain;
• encephalitis;
• various injuries and damage to the head;
• circulatory disorder in the hypothalamus;
• metastases with malignant tumor (cancer) in the brain (they ways to impede the full activity of the pituitary);
• genetic factors contributing to the emergence of this pathology.

Nonachar diabetes during pregnancy

In pregnant women, non-soldering diabetes occurs in a more complex form, which is due to the general changes occurring in the body.

When identifying this disease, it is necessary to systematically attend a doctor to diagnose a diagnosis in a timely manner, to assist and choose the right treatment. For general symptoms of renal illness, pregnant women add thirst at night and incontinence urin during sleep.

The manifestation of this disease in the absence of constant medical control and treatment leads to certain complications during pregnancy.

These include possible dehydration associated with a low level of sodium in the blood, lesion of the brain, arrhythmia, arterial pressure problems and insufficient production of oxytocin necessary for generic activities (its disadvantage affects the weakening of bages).

What drugs to treat nonachear diabetes

• Vasopressin - a hormone generated by a hypothalamus, which increases the reabsorption of water by the kidneys, preventing the dehydration of the body.
• Desmopressin - a synthetic analogue of a vasopressin that helps reduce diuresis; It is used to treat non-soldering diabetes.

The drug of choice in the treatment of CND is synthetic (genetically engineering) arginine-vasopressin (desmopressin; 1-deamino-8, d). The soluble form of the drug is applied either intranasally, 1-2 drops (10-20 μg) 1-2 times a day, or subcutaneously, 5-10 units 2-3 times a day. The tablet form contains in 1 tablet 100 or 200 μg. Dose is selected individually. It ranges from 1 to 3 tablets per day.

Oil solution of vasopressin prolonged action, Vasopressin Tannate, introduced in / m, at a dose of 2.5-5, pre-slightly heated and thoroughly stabbed the ampoule.

In cases of relatively easy CND flow (type 2, 3, 4), you can use the anticonvulsant preparation of Finlepsin (Tegretol), at a dose of 200-600 mg 2 times a day, a clofibrate of 500 mg 4 times a day or chloropramide 200-300 mg 1 time in a day. In neoprogenous nonachon diabetes, hypothiazide 50-100 mg in days or other diuretics, reinforcing sodium excretion. This treatment requires a mandatory restriction in the food diet of salt and continuous control of serum potassium.

Timely diagnostics and effective therapy of non-soldering diabetes are necessary not only to improve the quality of life of patients, but in order to prevent the imbalance atony with subsequent hydronephrosis.

Adequate treatment is particularly relevant for the elderly, in which there is a real danger of severe dehydration with damage to the central nervous system as a result of violation of the functions of a thirst center.

Treatment of unsax diabetes in children

Nonache diabetes in a child belong to idiopathic. It can begin at any age. With idiopathic form, the lack of antidiuretic hormone depends on the dysfunction of the hypothalamic-pituitary axis. It is assumed that in this area there is a congenital biochemical defect, which is manifested by symptoms if adverse environmental factors affect the body.

Nonachar diabetes in children may have post-traumatic etiology. It may occur as a result of damage that occur above the stem of the pituitary gland during the injury of the skull with the fracture of the base of the skull and the gap of the pituitary stem or after neurosurgical operations and manipulations.

Permanent polyuria may appear after a long time after injury - 1-2 years. In such cases, doctors find out the condition of the child during this time, trying to find a short time when typical symptoms could manifest. Such a cause of unsax diabetes as random injuries of the skull is extremely rare.

The cause of absolute insufficiency of the antidictic hormone can be the defeat of the neurohypophysis of any of the listed reasons:

• histiocytosis
• tumors over the Turkish saddle and in the area of \u200b\u200bthe viewing nerve
• fracture of the base of the skull, operational intervention
• infections (tuberculosis, encephalitis)
• wolframa syndrome
• hereditary forms

• 2-3 times a day, a child gives 0.5 cups of pickled sauerkraut, in which a lot of lactic acid. Or give 4 times a day. Fresh red beet juice for 1/4 cup.
• In 250 grams of water lay 1 tbsp. l. Leaf and young blueberry shoots, boil on low heat for 10 minutes, cooled and braid. Give a child 6 times a day at a quarter of a cup.
• In 250 grams of water lay 1 tbsp. l. Planting seeds, boiling for 5 minutes, put cool, then filtered. Give a child 3 times a day on one tablespoon.
• In one glass of water is divorced 2 tbsp. Spoons of juice from roots and leaf leaves. The resulting mixture is divided into 3 receptions, you need to drink for 1 day (3 times). From the May root of the burdock, sometimes make a salad, which is considered a good means of phytitutication of unacceptable diabetes.
• At the beginning of the disease 1 tbsp. A spoonful of chopped aspen bark is poured with two glasses of water and boil on a small fire. Then they wrap, insist about 3 hours, filter and give a child 3 times a day along the sixth part of the glass, you need to give infusion before meals, the course from 2 to 3 months.

The course of treatment of non-soldering diabetes is selected for children individually.

With a congenital disease, it will take regular administration of glucose intravenously. Such procedures are prescribed to children under three years.

The replacement therapy is not carried out. For the treatment of kids over three years old are used other drugs. If there is complications, there is a need for an operation.

Preparations for treatment in children of unacceptable diabetes

Preparations used in the treatment of unsax diabetes in children:

1. Intravenous administration of a synthetic substitute for vasopressin (desmopressin).
2. Therapy with drugs stimulating the production of their own vasopressin hormone (chloropramide).
3. Treatment with means reduced by the amount of sodium in the blood (clopamide, indapamide).
4. Reception of analogs of antidiuretic hormone (Vazomirin, minilin, adiratetine SD).

Diagnosis of non-soldering diabetes

Correctly diagnose and distinguish the diabetestenness of a certain type of polydipsey, by conducting diagnostics in several steps.

Differential diagnosis of unacceptable diabetes in outpatient conditions begins with a patient polling and finding out the following:

• the amount of drilled liquid, the separation of urine per day;
• the presence of night thirst and night enuresis;
• the presence of a psychological cause of thirst, private urinary calls for urination (when a person is distracted - the symptoms disappear);
• there are provocative diseases (tumors, injuries, violations by endocrinology).

If, after survey, all the symptoms indicate the presence of a disease, then a medical examination is carried out, based on the results of which is diagnosed and treatment is appointed.

The survey includes:

1. Ultrasound kidneys;
2. blood test,
3. urine (osmolarity, density);
4. computer tomography of the brain;
5. zimnitsky test is carried out;
6. the level of sodium, potassium, nitrogen, glucose, urea in blood is determined.

Treatment of renal unacceptable diabetes

Medical treatment

Treatment of renal non-soldering diabetes is practiced the purpose of medicinal substances, which, as neither paradoxical, reduce the amount of urine - thiazid diuretics (diuretic):

1. Hydrochlorothiazide,
2. Indapamide,
3. Triampur.

Their use is based on the fact that they prevent the reverse absorption of chlorine in the urinary channels of nephron. As a result, the sodium content in the blood decreases somewhat, and the inverse absorption of water is enhanced.

As a supplement to treatment, anti-inflammatory drugs are sometimes prescribed (ibuprofen, indomethacin and aspirin).

Their use is based on the fact that they reduce the flow of some substances into the urinary tubes of nephrone, thereby reducing the volume of urine and increasing its osmolalism. However, the successful treatment of non-soldering diabetes is impossible without complying with some power rules.

Diet

Nutrition with non-car diabetes has goals - a decrease in urine release in large volumes and thirst, as well as the replenishment of nutrients that are lost with urine.

Therefore, in the first place, the use of salt is limited (no more than 5-6 grams per day), and it is issued in hand, and food is prepared without adding it.

Drinks are useful because they contain potassium, which enhances the production of endogenous (internal) vasopressin. In addition, it is necessary to abandon sweets in order not to strengthen thirst. It is also recommended to refrain from the use of alcoholic beverages.

The food includes a sufficient amount of fresh vegetables, berries and fruits, milk and milk-acidic products.

In addition, juices, compotes, frost are useful.

It is very important that phosphorus flows into the body (it is necessary for normal work of the brain), so it is recommended to use low-fat varieties of fish, seafood and fish oil. In addition, low-fat varieties of meat and egg (yolk) are useful.

However, it is necessary to remember that during non-car diabetes still follows limit Proteins not to enhance the burden on the kidneys. Whereas fats (for example, butter creamy and vegetable), as well as carbohydrates (potatoes, pasta and others) shouldpricing in a diet in sufficient quantity. It is advisable to eat fractionally 5-6 times a day. Most fully complies with all these recommendations Table No. 7 or No. 10.

Nonachar diabetes treatment of folk remedies

The treatment of unacceptable diabetes by folk remedies can not make a proper effect, unless accompanied by medication therapy. When folk medicine is combined with traditional methods, the effect can be reinforced, and the amount of medicines is reduced over time, but not reduced to zero.

The first thing that the traditional medicine offers is sharply limited in the diet of the patient salt and increase the dose of milk. Instead of fried meat, it is recommended to eat boiled, as well as more egg yolks, fish. Desired in the menu of patients with diabetes unacceptable crayfish and brains.

Orekhi

Very helpful in treating people's nonachonal diabetes, walnuts. Daily rate - 100 grams of nucleoli. But while nuts are not ripe, thirst can be a good thickening of young leaves of walnut.

Five grams of leaves grind, poured boiling water in the amount of 200 milliliters, insist and drink instead of tea. All this helps to stop the development of the disease.

Among popular recipes are as follows:

1. Connect 1 part of the root of Aira and Valerians, 2 pieces of fennel seeds and grass blue grass, 5 pieces of Veronica grass, chabar and labānik. In the evening 1 tbsp. The resulting mixture is brewed in a thermos 500 ml of boiling water, insisted overnight, strain. Take the next day, in three receptions for half an hour before meals. The course of treatment lasts 2-3 months.
2. Connect 1 part of the colors of a tricolor violet, 2 pieces of linden and herbs white. White mistletoe, 3 parts of the Bolotnie Range Colors, 4 parts of the Hypericum, souls and plantain. In the evening 1 tbsp. The resulting mixture is brewed in a thermos 500 ml of boiling water, insisted overnight, strain. Take the next day, in three receptions for half an hour before meals. The course of treatment lasts 2-3 months.
3. Connect 1 part of the root of the root of fragrant, 2 parts of the colors of daisy and dill seeds, 3 pieces of the Grass of the Hypericum and the Celebrations of the Medicinal, 4 parts of the licorice root, 5 pieces of the oregano. In the evening 1 tbsp. The resulting mixture is brewed in a thermos 500 ml of boiling water, insisted overnight, strain. Take the next day, in three receptions for half an hour before meals. The course of treatment lasts 2-3 months.

Winning thirst

Rollen the thirst for patients help plants.

Lopeh.

Until the autumn, the Savior serves Burning.

More precisely, its roots. If they are grinding into powder, then a teaspoon of such powder, diluted in half a glass of heated milk, quenched thirst.

You can make a drink from the burdock from the evening to the entire subsequent day. For this, 60 grams of roots are crushed, poured a liter of boiling water and leave overnight. In the morning, an infusion was filtered by infusion, if the thirst arises, 130 milliliters.

Elder

Well helps infusion of black elderberry flowers. 20 grams of flowers insist in 200 milliliters boiling water at least an hour, filtered, add a teaspoon of honey and drink three times between feeding food.

Wins thirst and propolis

Before propolis, swallow, a couple of minutes you need to chew it. Effective tool in folk medicine is considered the infusion of herbs.

It is necessary to take the chopped dandelion root, lingonberry leaves - three tablespoons, two - leaves of nettle dwarfish, daisy flowers, Veronica grass, birch buds. Mix everything well.

The mixture in the volume of the tablespoon is poured with boiling water in the amount of 200-250 milliliters, insist for three hours. The effects of infusion should be drunk in half an hour before receiving food, 100 milliliters.

Pea flour, herb grass

In folk medicine, in the treatment of diabetes, pea flour, the grass of the mother-in-law is used. The disease occurs hard, with attacks.

For their removal, glycerin pharmacy is used.

Glycerin's tablespoon is enough to learn pain.

You can fight the disease and need, this disease is not a sentence and treatable.

For this, it is necessary to follow the advice of specialists, including representatives of traditional medicine.

Video: Live great! Nonachar diabetes

Nonacharic diabetes (or inexpensive diabetes) is a rare chronic, associated with a violation of the hypothalamus function, or pituitary, which is characterized by abundant urination and thirst. Why does this disease appear and is it possible to cope with this problem?

Everyone knows such a disease like diabetes mellitus, but few people have heard of unacceptable diabetes. Despite the fact that these diseases for the sound almost coincide, they mean not the same thing. Nonacharic diabetes is a violation of the function of the pituitary gland, or the hypothalamus. There is a disease when the body occurs sharpness of the lack of peptide hormone hypothalamus - vasopressin, or antidiuretic hormone (ADG). Nonacharic diabetes occurs very rarely, about 3 people out of 100 thousand suffer from this ailment. Consider how unacceptable diabetes in women are manifested.

Nonachar diabetes has two main types.

1. The first view is associated with the pathologies of the head or hypothalamus. Called centralm. It develops due to disruption or formation of vasopressin. The first type is symptomatic and idiopathic. Symptomatic may appear due to diseases of the body due to various reasons (concussion of the brain, encephalitis). Idiopathic develops as a result of heredity.
2. The second view is called renal. It appears due to a decrease in the sensitivity of the kidney tissue to the effects of the same vasopressin. This type of diabetes is much less common than the first. The kidney diabetes can develop as a result of damage to kidney cells with drugs or, if there is a congenital predisposition.

Symptoms of unsax diabetes

The disease can appear suddenly, and may arise and develop gradually for a long time.

The main and primary signs of the appearance of non-soldering diabetes are the abundant allocation of urine from 6 to 15 liters. For a day and strong thirst, these symptoms are particularly characteristic for night time.

Nonachar diabetes in women has almost the same signs as men with the exception of some:

• violation of the cycle of menstruation;
• infertility;
• a pregnant woman can have a miscarriage.

In addition to the above, the following symptoms are observed:

• body dehydration;
• the mucous membranes of the mouth and the skin becomes dry;
• the body weight is sharply reduced;
• the stomach becomes bloated, lowers down;
• disappearance of appetite;
• constipation arise;
• the bladder is stretched;
• the selection of sweat is practically not felt;
• heart beats often, sometimes falling blood pressure;
• rarely possible nausea or vomiting;
• man is quickly tired;
• it is possible to increase the temperature;
• enuresum may appear;
• insomnia, bad sleep;
• pain syndrome in the head;
• man becomes irritable;
• mental activity is significantly reduced.

Note! Symptoms of the disease in men and women are different. For women, the launched state of the disease may threaten infertility and miscarriage.

Causes of unacceptable diabetes in women

Causes depend on the type of disease. In the first type they are:

• tumor in the hypothalamus;
• complications after operations on the brain;
• encephalitis;
• various injuries and damage to the head;
• circulatory disorder in the hypothalamus;
• metastases with malignant tumor (cancer) in the brain (they ways to impede the full activity of the pituitary);
• genetic factors contributing to the emergence of this pathology.

From the side of the renal system, the causes are:

• congenital diabetes;
• kidney pathology;
• serpovoid cell anemia;
• amyloidosis;
• polycystic kidney disease;
• insufficiency in the kidneys of chronic type;
• reception of medicines that adversely affect the kidneys and their fabric.

The reasons for the appearance of unacceptable diabetes also become:

• reduction of calcium element;
• increased potassium element;
• syphilis;
• ARVI, flu or similar diseases;
• elderly age;
• people often ill or dismissed diseases, etc.

Important!About about 1/3 cases of dissaturated diabetes are incomprehensible. In most situations, doctors never managed to explain on the basis of which the disease appeared.

Methods of detection of the disease

The disease is easy to detect. A doctor who is engaged in similar pathologies is an endocrinologist. If you feel most of the symptoms of this disease, the first thing is to go to the endocrinologist.

At the first visit, the doctor will hold a "interview". It will allow you to find out how much water a woman drinks per day, whether there are problems with the menstrual cycle, urination, it has endocrine pathologies, tumors, etc.

If, after such a preliminary examination, the doctor notices the presence of unsax diabetes, then the patient is poisoned into additional procedures.

Important!A specialist who is engaged in treating and can confirm the presence of unacceptable diabetes - this is an endocrinologist.

Several types of surveys are used to detect non-sold diabetes.

The endocrinologist can also send an examination to a neuropathologist and neurosurgeon.

Thanks to various methods of diagnosis and surveys, various specialists can accurately diagnose and reveal at what stage there is a disease.

Complication of unacceptable diabetes in women

Incoming diabetes a dangerous disease, as it has many consequences and complications for the body.

Complications of the disease:

1. Termination of drinking. Some patients believe that if they won't drink a lot, then the desire of urination will decrease, but this is not so. If a person stops drinking to drink, empties will still take place. In addition, the body will begin the strongest dehydration, the body weight will begin to decrease, etc.
2. The use of excessive amounts of water. A person who drinks is more than it is supposed to get a stretch of the stomach, the bladder also stretches, and renal lochs will stretch.
3. Cardiovascular system is violated.
4. The nervous system with complication of the course of the disease suffers even more. Neurosis appear, depression, a person can not sleep.
5. The menstrual cycle is broken.

Important!With unacceptable diabetes, it is impossible to rearrange to drink, but also you can not drink too much. It is advisable to drink only water, moderately, in small sips.

All these complications usually appear when a person does not understand what he needs to ask for help to doctors or does not want to do this. With incommary diabetes, the patient's condition deteriorates quite quickly and can lead to death, only timely appeal to the doctors will correct this situation.

Treatment of unsax diabetes in women

Nonacharic diabetes is treated by eliminating the cause of its appearance, if this is possible, and therapy itself is prescribed depending on the type of illness.

Treatment of 1 type

In central diabetes therapy, it is important to establish how many liters of liquid loses a woman and on the basis of this, the doctor decides which to prescribe drugs or can be limited to a special diet.

Medicinal preparations that are used to treat the first-type central diabetes:

1. Minin.
2. Chlorpropamide.
3. Carbamazepine.
4. Myckeron.

Minin

A medication having an antidiuretic action is used as substitution therapy. In its composition, there is a substance of desmopressin, which is similar in its structure with a hormone of the pituitary gland to vasopressin.

Minimine is used inside during food intake. Dose medication is determined for each patient individually. An hour before the reception of the tablets, it is recommended to reduce the amount of fluid from the drink and control this process for another 8 hours after the adoption of the medication.

Carbamazepine, chlorpropamide, myckeron Used to stimulate the production of vasopressin hormone.

Treatment of type 2

With second type therapy is also important to ensure fluid flow into the body. Among the drugs are prescribed diuretic diuretics, which reduce the amount of urine produced, anti-inflammatory means.

Medicines that reduce urine production, for example, Indapamide or Triampur.

These drug drugs are used with the goal to prevent, stop the reverse chlorine suction process in the kidney channels. As a result, there is a decrease in the blood of the amount of sodium and the reinforced process begins, in which the water is inversely absorbed into organs and tissues.

Anti-inflammatory drugs under this disease are used to reduce the admission of substances into the urinary channel of the nephron, which helps to reduce the amount of urine and increase its osmolality.

Note!Medicinal preparations are presented for familiarization and are not appointment. Do not take medication as therapy in this disease yourself, be sure to consult a specialist.

Video - Nonachar Diabetes

Nutrition with diabetes nonaxing

In the treatment of unsax diabetes, mandatory compliance with due nutrition is required.

Diet with a given disease suggests:

• reducing the amount of urine;
• quarreling thirst;
• replenishment of beneficial substances that are lost during emptying.

The diet is as follows:

1. Reduce salt use. Allowed only 5 - 6 grams. per day. In order to control the process of supplying salt into the body, it is recommended to prepare food without adding it, and there is it adding it to the food itself in the amount that is allowed.
2. Enable dried fruits in the menu. They contain a large number of potassium, which contribute to the production of vasopressin.
3. Exclude sweets. Sweet dishes and foods are thirsty, as well as alcohol, as well as sweet carbonated drinks, so they must be removed from the diet.
4. Fresh vegetables, fruits, berries, they contain many useful vitamins and substances.
5. Milk, fermented milk products are allowed.
6. Fresh juices, compotes (preferably home), the fruit will also be useful to enable in its menu.
7. Non-fat fish, seafood, meat are not fatty varieties.
8. Egg yolk. Proteins are not recommended, because they enhance the burden on the kidneys.
9. Fats (oil in any form), carbohydrates (pasta, bread, potatoes) must be necessarily included in the daily diet.

Each food is better often, but small portions. Description To divide food intakes for 5 - 6 servings per day.

Important!Power is an integral part of the treatment of unacceptable diabetes.

Popular Medicine with Nonachar Diabetes

Among the recipes of traditional medicine, many of those aimed at eliminating the symptoms that manifest themselves during non-car diabetes. We give some useful recipes.

Infusion of Lopuha

Ingredients:

• lopach root (60 gr.);
• boiling water (1 l.).

Preparation and application of infusion:

The root of the plant is crushed and fall asleep into the thermos. Pour the crushed root with steep boiling water. Insist if they are preparing from the evening, then until the morning. Take the infusion three times a day at 150 ml.

Benefit: Infusion significantly reduces thirst and the number of urine produced.

Infusion of dyeing

Ingredients:

• mother (1 part);
• valerian root (1 part);
• hop cones (1 part);
• rosehip fruits (1 part);
• mint (1 part);
• boiling water (250 ml.).

Preparation and application:

All plant ingredients are mixed and thoroughly crushed. Take 1 spoon of the mixture and poured boiling water. Insist hour. Taken in an amount of 70 - 80 ml. before bedtime.

Benefit: Infusion calms the body, relieves irritability, improves sleep.

Decoration based on immortelle and dolphinium

Ingredients:

• the inflorescences of immortelle (1 part);
• herb of dolphinium, or bias (part 1);
• boiling water (0.5 l.)

Preparation and application:

Plants are crushed and mixed. The mixture (1 tbsp) is poured with boiling water. Leave to not be up to the morning. Infusion is filtered and taken with an interval of 4 hours to 1/3 cup.

Benefit: Eliminates dryness in the oral cavity, quarrels thirst, reduces urination.

Nonacharic diabetes is a pathology that is caused by the insufficiency of vasopressin, its absolute or relative deficit.

Vasopressin (antidiuretic hormone) is secreted in the hypothalamus and, in addition to other functions, is responsible for normalization of the urinary process. Accordingly, with the causes of origin, it is customary to distinguish three types of this ailment: genetic, acquired, idiopathic.

Most of the patients who suffer from this rare disease still do not know the exact cause of its occurrence. Such inexpensive diabetes is called idiopathic and about 70% of patients suffer from it. Genetic unacceptable diabetes is caused by a hereditary factor. In this case, it is present in several family members or several generations to a row.

Prevalence

Nonache diabetes occurs relatively rarely. For example, in Uzbekistan, in the republic in 2012, 2295 people were registered with such a diagnosis, including 235 children. For every 100 thousand people of the entire population of the republic in 2012 accounted for 7.7 persons with such a diagnosis. Most patients in the country were aged 40 - 49 years - 530 people (22.9%). In children and adolescents of Uzbekistan, this disease occurs rarely - in 2012, only 2.7 children per 100 thousand children's population of the republic consisted.

Causes of development

Approximately 30% of cases of the cause of unauthorized diabetes remain uncertain. This is due to the fact that any diagnostic surveys are conducted, they do not show any diseases or factors that could serve as a cause cause.

The development of the central nonacharic diabetes is characterized by the violated level of secretion of ADG. This occurs due to the fact that an insufficient amount of vasopressin is produced in the hypothalamus, namely the intermediate department of the brain is responsible for the synthesis of ADG and the operation of the urethra. The causes of the disease can be the following factors:

• a brain tumor;
• head injuries;
• postoperative complications (operations on the brain);
• syphilis;
• sarcoidosis;
• encephalitis;
• multiple foci of lesion with tumors of lungs and chest;
• kidney disease;
• anemia (sickle-cell);
• congenital pathologies;
• renal failure;
• use of medicines that have toxically affect the kidneys;
• dysbalance potassium and calcium in the blood;
• polycystic;
• amyloidosis;
• magazine damage.

In the development of renal non-soldering diabetes, the disease proceeds in reverse order: the body produces vasopressin at a sufficient level, but the renal tissues do not give reactions on it.

Central Nonachar Diabetes

The development of the central or hypothalamic-pituitary nonacharic diabetes occurs due to the inability of the kidneys to the accumulation of fluid. This pathology arises due to disorders arising in the functions of the distal tube of nephron. As a result of a patient with this form of unacceptable diabetes, suffering from a rapid urination in a complex with polydipcia (that is, the syndrome of the neatoly thirst).

It should be noted that if the patient has the possibility of unlimited consumption of water, then there are no threats for its state. If there is no such possibility for one or another reasons, and the patient cannot quench the patient on time, dehydration (or hyperosmolar dehydration) is rapidly starting to develop. The achievement of the extreme stage of this syndrome is dangerous for the sickness of the patient, because the subsequent stage becomes the transition to the hyperSolar to whom.

The long-term course of the central unacciation diabetes for the patient develops into renal insensitivity in relation to artificially administered in therapeutic purposes of antidiuretic hormone. For this reason, the earlier the treatment of this form of non-soldering diabetes will begin, the forecasts of the subsequent state of the patient become more favorable.

It should also be noted that significant volumes of patients consumed by the liquid may cause such conditions associated with this disease, like dyskinesia of the biliary tract, the development of irritable bowel syndrome or the omission of the stomach.

Renal unacceptable diabetes

The disease in unacceptable diabetes in this form is provoked by organic or receptor pathologies of kidneys, including a enzymatic enzyme. The form is quite rare, and if it is noted in children, then, as a rule, in this case it is congenital. Causes its mutations in the Aquaporin-2 gene or the vasopressin receptor mutation.

If we are talking about the acquired form in the incidence of adults, it is advisable here to note the renal failure, provoking this form of diabetes, regardless of the characteristics of its etiology. In addition, the renal unacceptable diabetes may also occur due to long-term therapy using lithium preparations and other specific analogues.

Idiopathic unacceptable diabetes

The incidence of unsax diabetes in this form is one third of the cases. Here, in particular, we are talking about the absence in the process of diagnostic visualization of the pituitary gland of any kinds of organic pathologies of the organ. In other words, the specified frequency of incidence of unsax diabetes is unknown. In some cases, its transfer is possible.

Symptoms

The earliest sign of unailed diabetes is polyuria - an increase in diuresis. On average, patients have an increase in diuresis to five and six liters of urine per day. Issues for urination occur even at night. When restricting water intake, the patient's condition deteriorates: headache, heartbeat, decrease in blood pressure, fever, vomiting, psychomotor excitation.

Against the background of excessive loss of fluid, a compensatory polyudipsy arises - thirst. Moreover, it is characteristic that it is thoroughly succeeded only with cool water. In addition, dry skin and mucous membranes are observed, as well as a decrease in saliva and sweating.

In babies, clinical symptoms differ from those in adults. This is due to the fact that if there is thirst, the child cannot inform about it, which means that the lost liquid does not fully resume fully. Children have such symptoms:

1. Loss of body weight;
2. Developmental delay;
3. Pallor skin;
4. Lack of appetite;
5. Lack of tears and sweat;
6. Vomiting;
7. Increase body temperature.

Symptoms of unacceptable diabetes in men are a decrease in sexual entraints and potency.

Symptoms of unsax diabetes in women: disorders of the menstrual cycle up to amenorrhea associated with this infertility, and in case the pregnancy still has come - an increased risk of spontaneous abortion.

Please note: in early age children against the background of dehydration, hypernatremia and hyperosmolarity of blood are rapidly developing, accompanied by the emergence of convulsion and the development of coma.

Diagnostics

If suspicion of unacceptable diabetes, you need to contact the endocrinologist. Patients additionally visit neurosurgeon, neuropathologist, oculist. Women should receive a consultation of the gynecologist.

It will be necessary to pass some studies. To reveal non-soldering diabetes:

1. Examine the urine and blood of the patient;
2. Sample Zimnitsky;
3. Make ultrasound kidneys;
4. Conds CT or MRI brain, echohetephalography.

Laboratory tests will allow to evaluate blood osmolarity, relative density and osmolarity of urine. Biochemical blood test provides an opportunity to obtain data on the level of glucose, nitrogen, potassium, sodium and other substances.

Diagnostic indicators of the disease:

• Low urine osmolarity (less than 100-200 mos / kg);
• High sodium content in blood (from 155 meq / l);
• Reduced relative urine density (less than 1010);
• Elevated blood plasma osmolarity (from 290 mos / kg).

Nonachar and diabetes are easy to distinguish. In the first case, the patient's urine does not detect sugar, the blood glucose level does not exceed the norm. Code of the disease according to the ICD-10 - E23.2.

The main pathological conditions from which neurogenic non-sea diabetes should be distinguished:

• psychogenic polydipsy;
• chronic renal failure;
• diabetes;
• nephrogenous unacceptable diabetes.

Differential diagnosis

Common symptoms for non-soldering diabetes and psychogenic polydipsia are increased thirst and frequent abundant urination. However, the psychogenic polydipsee develops not suddenly, but gradually, with the patient's condition (yes, this disease is inherent in women) does not change significantly. In a psychogenic polydipsy, there are no signs of blood thickening, symptoms of dehydration are not developed in the event of a sample with a limitation of fluid: the volume of the urine released decreases, and its density becomes greater.

Chronic renal failure can also accompany the thirst and abundant diuresis. However, this condition is also accompanied by the presence of urinary syndrome (protein, leukocytes and erythrocytes in the urine, not accompanied by any external symptomatic) and high diastolic (in the people - "lower") pressure. In addition, with renal failure, the increase in blood levels of urea and creatinine is determined, which during non-car diabetes are within the normal range.

In diabetes mellitus, in contrast to the inexpensive, the high level of glucose is determined in the blood, and the relative density of urine is increased and glucose is noted (glucose selection with urine).

Nephrogenous unacciation diabetes for clinical manifestations is similar to its central form: a strong thirst, frequent abundant urination, signs of blood and dehydration thickening, low urine's share - all this is also inherent in both the other forms of illness. The difference between the peripheral form is a normal or even elevated level of antidiuretic hormone (vasopressin) in the blood. In addition, in this case there is no effect from diuretic drugs, since the cause of the peripheral form is the insensitivity of the receptors of the kidney channels of the adg.

How to treat nonachear diabetes?

At the heart of the treatment of non-soldering diabetes replacement therapy with synthetic analogues of vasopressin. To preparations that can compensate for the level of antidiuretic hormone in the body include desmopressin or adiratetine. They are produced in the form of tablets or nasal sprays. In the treatment of unsax diabetes, tableted desmopressin applies dosages to 0.4 mg 3-4 times a day. Injecting fluid in the nose with synthetic vasopressin should also be carried out at least 3 times a day.

Treatments with a longer effect of action, such as Pitresin Tanat, are also used in the treatment of non-soldering diabetes. It can be used 1 time in 3-5 days. Dietherapy plays an important role in the treatment of non-soldar diabetes. All patients with a deficit of antidiuretic hormone in the body are encouraged to feed and increase the amount of complex carbohydrates in the diet (potatoes, vegetables, grain, legumes, meat, nuts).

Stimulating the production of natural vasopressin with an incompletely form of unacceptable diabetes is carried out with chlorpropamide and carbomasic preparations.

Patients with a pituitary tumor show the surgical treatment of non-soldering diabetes - removal of the tumor and, if necessary, radioactive exposure.

Diet and nutrition

The main task of dietotherapy is to reduce urination, and in addition, replenishment of the body with reserves of vitamins and minerals, which they "lose" due to frequent urges to the toilet.

It is worth preferred to prepare exactly in such ways:

• boil
• for a couple;
• stew products in a saucery with olive oil and water;
• bake in the oven, preferably in the sleeve, for the preservation of all useful substances;
• in a slow cooker, in addition to the "Fry" mode.

When a person has a unacceptable diabetes diet should exclude those categories of products that increase thirst, such as sweets, fried dishes, spices and seasonings, alcohol.

The diet is based on such principles:

• reduce the amount of protein consumed, leaving the norm of carbohydrates and fats;
• reduce salt concentration by reducing its consumption up to 5 g per day;
• food should consist mainly of vegetables and fruits;
• for quenching thirst, use natural juices, fruits and compotes;
• consume only lean meat;
• include fish and seafood, egg yolks;
• take fish fat and phosphorus;
• feed often in small portions.

Approximate menu for the day:

• first breakfast - omelet (for a couple) of 1.5 eggs, vinaigrette (with vegetable oil), lemon tea;
• second breakfast - baked apples, kissel;
• lunch - vegetables soup, boiled meat, beets stew, lemon drink;
• afternoon snack - a decoction of rosehip, jam;
• dinner - boiled fish, boiled potatoes, sour cream, lemon tea.

Abundant beyonium is necessary - because the body loses a lot of water during dehydration and it needs to be compensated.

Folk media

Successive fees are applied to improve sleep and reduce irritability:

1. Take in equal parts of the chopped roots of Valeriana, the fruits of fennel and cumin, the herbs of the motherboard and mix everything thoroughly. Then take two tablespoons of raw materials from the resulting mixture and fill with 400 ml of boiling water, let it be up to cooling and seitoring. Take half a glass with irritability or nervous excitation.
2. Take in equal parts of the chopped roots of Valeriana, the bumps of hops, herbs of the mother-in-law, the fruits of the rosehip, the leaves of mint and mix everything thoroughly. From the resulting mixture, take one tablespoon of raw materials and pour the glass of boiling water. Let's launch within an hour, and then bequely. Take 1/3 cups overnight with insomnia or increased nervous excitation.

To reduce thirst:

1. Take 60 grams of crushed root of burdock, place in the thermos and pour with one liter of boiling water. Leave for the night, and in the morning you are writing. Take two thirds of the glasses three times a day.
2. Take 20 grams of bezen flowers, pour boiling water with glass and leave for an hour. Then write and add honey to taste. Take one gland three times a day.
3. Take 5 grams (one teaspoon) of crushed young leaves of walnut and pour a glass of boiling water. Let's launch and take like tea.

What is the forecast?

The forecast of non-soldering diabetes mainly depends on which form is diagnosed in the patient. The bulk of patients with unsax diabetes has a favorable forecast for vital activity, but not for recovery. Nonachar diabetes does not affect the performance and lifespan, but it can significantly reduce its quality.

With a pronounced nonachon diabetes, most patients set 3 disability groups. If unacceptable diabetes is symptomatic - then recovery occurs when removing the reason. If the disease was caused by injury, then after treatment it is possible to restore the functions of the pituitary gland. If not to treat non-soldering diabetes, then the dehydration of the body will cause the development of the stupor and the subsequent coma.