Extreme polyuria: Decompensated diabetes mellitus and/or diabetes insipidus?

Delhaye, François; Vincent, Jean‐Louis; Féry, Françoise; Pirotte, Benoît; Unger, Jonathan

doi:10.1007/bf01706207

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…An interesting finding was that the high water consumption in diabetes insipidus (di/di) animals was further increased by DM, so the diuresis due to AVP deficiency was additive, with the osmotic diuresis caused by DM. This fact can have special importance in some clinical situations, for example, during gestation or in diabetic nephropathy (5,18), because the consequences of a combination of DM and diabetes insipidus can be extremely severe (14). Therefore, diabetes insipidus (incidence rate: ϳ1 in 6,666 in the US) seems to be an additional serious risk factor for DM and thus a potential target for prevention and/or therapeutic intervention.…”

Section: Discussionmentioning

confidence: 99%

Hypothalamic paraventricular nucleus, but not vasopressin, participates in chronic hyperactivity of the HPA axis in diabetic rats

Zelena¹,

Filaretova²,

Mergl³

et al. 2006

American Journal of Physiology-Endocrinology and Metabolism

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Zelena, Dóra, Ludmila Filaretova, Zsuzsa Mergl, István Barna, Zsuzsanna E. Tóth, and Gábor B. Makara. Hypothalamic paraventricular nucleus, but not vasopressin, participates in chronic hyperactivity of the HPA axis in diabetic rats. Am J Physiol Endocrinol Metab 290: E243-E250, 2006. First published September 6, 2005 doi:10.1152/ajpendo.00118.2005.-Diabetes mellitus (DM), as chronic stress activates the hypothalamopituitary-adrenocortical axis. We examined whether arginine vasopressin (AVP) and the hypothalamic paraventricular nucleus (PVN) participate in DM-induced chronic stress symptoms. AVP-deficient Brattleboro or PVN-lesioned Wistar rats were used with heterozygous or sham-operated controls. The rats were studied 2 wk after a single injection of streptozotocin. The appearance of DM (enhanced water consumption and blood glucose elevation) and the chronic stress-like somatic changes (body weight decrease, thymus involution, adrenal gland hypertrophy) were not influenced by the lack of AVP. By contrast, PVN lesion significantly attenuated DM-induced thymus involution and adrenal gland hypertrophy as well as the increase in water consumption. The corticotropin-releasing hormone mRNA in PVN was diminished by DM and elevated by the lack of AVP without interaction. DM elevated the proopiomelanocortin (POMC) mRNA in the anterior lobe of the pituitary. The lack of AVP had no effect, whereas lesioning the PVN significantly diminished the elevation. The elevated basal corticosterone plasma levels detectable in DM were influenced neither by the lack of AVP nor by lesioning the PVN. Thus the lack of AVP had no influence on DM-induced chronic stress symptoms, but lesioning the PVN attenuated part of them. However, the lack of elevation in POMC mRNA after PVN lesion, together with the maintained corticosterone elevation, suggests that direct adrenal gland activation occurs in untreated DM. chronic stress; Brattleboro rats; corticosterone; proopiomelanocortin; corticotropin-releasing hormone; diabetes mellitus; hypothalamopituitary-adrenocortical axis DIABETES MELLITUS (DM) is an endocrine disorder that is quite common in developed countries (17). Inadequate insulin secretion and insulin resistance with inadequate compensatory insulin release are the main reasons for DM development. The use of toxic agents that destroy ␤-cells in the pancreas and lead to insulin deficiency, such as streptozotocin (STZ), produces a model of DM in animals (36). The most frequent symptoms of DM are blood glucose level elevation, polyuria, polydipsia, and weight loss. However, the long-term disorder can cause many other complications, including cardiovascular, cerebrovascular, or renal ones.Long-term DM as a chronic stress may also induce a dysfunction of the hypothalamo-pituitary-adrenocortical (HPA) axis. A tight connection between HPA axis activity and blood glucose regulation is well known (9, 12). The HPA axis is responsible for the production of glucocorticoids, which are important adaptive hormones. Glucocorticoid hormones participate...

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Section: Discussionmentioning

confidence: 99%

Hypothalamic paraventricular nucleus, but not vasopressin, participates in chronic hyperactivity of the HPA axis in diabetic rats

Zelena¹,

Filaretova²,

Mergl³

et al. 2006

American Journal of Physiology-Endocrinology and Metabolism

View full text Add to dashboard Cite

show abstract

“…CDI combined with DKA has been highlighted in only a small number of case reports (13)(14)(15)(16)(17). If both occur at the same time, it may be difficult to make a precise diagnosis, which can pose a serious threat to a patient's life.…”

Section: Discussionmentioning

confidence: 99%

“…Anti-rabphilin-3A antibodies are found in the majority of patients with LINH (12). Coexistence of CDI and DKA is rare, with only few published reports, and the causal relationship has not yet been addressed (13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Ketoacidosis, Hypertriglyceridemia and Acute Pancreatitis Induced by Soft Drink Polydipsia in a Patient with Occult Central Diabetes Insipidus

et al. 2022

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A 21-year-old Japanese man without known diabetes mellitus had abdominal pain. The diagnosis was ketoacidosis and hypertriglyceridemia-induced acute pancreatitis. He had polydipsia and polyuria and had habitually drunk several soft drinks every day for two years. After hospitalization, despite adequate liquid intake, dehydration remained with hypotonic polyuria. Further examinations revealed the coexistence of central diabetes insipidus (CDI), possibly caused by lymphocytic infundibulo-neurohypophysitis, based on antirabphilin-3A antibody positivity. Although CDI had been undiagnosed for two years, over-consumption of sugar-rich soft drinks to ease thirst caused ketoacidosis, hypertriglyceridemia, and acute pancreatitis. There are no previous reports of this three-part combination of symptoms caused by CDI.

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The role of vasopressin in diabetes mellitus-induced hypothalamo-pituitary-adrenal axis activation: Studies in Brattleboro rats

Zelena

Mergl

Makara

2006

Brain Research Bulletin

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Extreme polyuria: Decompensated diabetes mellitus and/or diabetes insipidus?

Cited by 5 publications

References 18 publications

Hypothalamic paraventricular nucleus, but not vasopressin, participates in chronic hyperactivity of the HPA axis in diabetic rats

Hypothalamic paraventricular nucleus, but not vasopressin, participates in chronic hyperactivity of the HPA axis in diabetic rats

Ketoacidosis, Hypertriglyceridemia and Acute Pancreatitis Induced by Soft Drink Polydipsia in a Patient with Occult Central Diabetes Insipidus

The role of vasopressin in diabetes mellitus-induced hypothalamo-pituitary-adrenal axis activation: Studies in Brattleboro rats

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