Polyuria in diabetes occurs when you have excess levels of sugar in the blood. Normally, when your kidneys create urine, they reabsorb all of the sugar and direct it back to the bloodstream. With type 1 diabetes, excess glucose ends up in the urine, where it pulls more water and results in more urine. As we mentioned above the dehydration that results from polyuria, or excessive urination, can lead to kidney problems—or even diabetic ketoacidosis, which can be life-threatening.
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Polyuria is a medical term that describes excessive urination. Outside of drinking an unusually excessive amount of water, excessive urination could indicate underlying medical conditions. The most common causes of polyuria are diabetes mellitus and diabetes insipidus. In addition, polyuria can be caused by medications, caffeine, alcohol, kidney disease, and electrolyte imbalance.
Urine is created in the kidneys with water and solids filtered from the bloodstream. Adult should generally void no more than 2. Polyuria occurs when an adult produces more than 3 liters, regardless of how often he or she urinates. The prevalence of polyuria is not very well documented. Nocturia has been studied more than polyuria. There is evidence suggesting that nocturia and polyuria are both more common in older patients. Polyuria literally translates to "urinating too much" and may be the only symptom one experiences.
However, depending on the cause, there are other symptoms that can accompany polyuria. When the cause is either diabetes insipidus or diabetes mellitus, polyuria is usually coupled with excessive thirst polydipsia.
Frequent urination, especially at night nocturia , is often associated with polyuria, but it doesn't have to be. There are myriad causes of polyuria, which range from being as simple as drinking too much water to a serious health complication like kidney failure. The following causes of polyuria are the most common.
Diabetes mellitus is a condition caused by the body's inability to adequately control blood sugar, either because it is unable to properly manufacture insulin or a resistance to the effects of insulin.
Diabetes mellitus leads to higher osmolarity in the bloodstream because of increased sugar levels. Think of the blood as a bit syrupy in a patient with diabetes mellitus. The kidneys must work to filter out the increased sugar by creating more urine. Diabetes insipidus is completely different from diabetes mellitus and doesn't have anything to do with blood glucose levels. Instead, diabetes insipidus is related to polyuria directly in its connection to arginine vasopressin AVP , an antidiuretic hormone.
Central diabetes insipidus is caused by a lack of arginine vasopressin secretion due to a neurological condition. Nephrogenic diabetes insipidus is due to failure of the kidney to respond to AVP. Central diabetes insipidus can be acquired from a medical or traumatic brain injury.
Nephrogenic diabetes insipidus is usually inherited. Certain medications are designed to increase urination to treat conditions like congestive heart failure and high blood pressure. Those medications can lead to polyuria if the dosages are not correct. Lithium is a medication used to control mood disorders.
It is almost entirely excreted from the body in urine and can have a profound effect on the kidneys in patients who take it regularly. Lithium can cause polyuria and polydipsia as a result of lithium-induced nephrogenic diabetes insipidus. If lithium is discontinued early enough once the polyuria is noticed, the symptoms can be reversed without any long-term damage.
However, if polyuria is present and lithium is not discontinued, irreversible damage to the kidneys can cause permanent polyuria. In rare cases, the kidney does not respond to AVP. This causes a specific form of diabetes insipidus called nephrogenic diabetes insipidus. People feel thirsty as the body tries to compensate for the increased loss of water by increasing the amount of water taken in. Find out more about the causes of diabetes insipidus.
In rarer cases, diabetes insipidus can develop during pregnancy, known as gestational diabetes insipidus. Cranial diabetes insipidus occurs when there's not enough AVP in the body to regulate urine production. It can be caused by damage to the hypothalamus or pituitary gland — for example, after an infection, operation, brain tumour or head injury.
In about 1 in 3 cases of cranial diabetes insipidus there's no obvious reason why the hypothalamus stops making enough AVP. Nephrogenic diabetes insipidus occurs when there's enough AVP in the body but the kidneys fail to respond to it. Some medications, particularly lithium used to help stabilise mood in some people with specific mental health conditions, such as bipolar disorder , can cause nephrogenic diabetes insipidus. You just need to increase the amount of water you drink to compensate for the fluid lost through urination.
Nephrogenic diabetes insipidus is often treated with medications called thiazide diuretics, which reduce the amount of urine the kidneys produce.
Find out more about treating diabetes insipidus. As diabetes insipidus increases water loss in the urine, the amount of water in the body can become low.
This is known as dehydration. Rehydration with water can be used to treat mild dehydration.
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