Acarbose Actoplus MET Actos Amaryl Apidra Avandamet Avandaryl Avandia Byetta Chlorpropamide Diabeta Diabinese Duetact Exenatide Injection Fortamet Glimepiride Glipizide (Glucotrol XL; Glipizide) Glipizide and Metformin Glipizide + Metformin (Glipizide and Metformin; Metaglip) Glucagen Glucagon (Glucagon; Glucagen) Glucophage Glucotrol XL Glucovance Glyburase Glyburide (Glyburide; Micronase; Glynase; Diabeta; Glyburase; Micronized Glyburide) Glyburide and Metformin Glyburide + Metformin (Glyburide and Metformin; Glucovance) Glynase Glyset Janumet Lantus Levemir Levora Metaglip Metformin (Metformin; Fortamet; Glucophage; Metformin Extended-Release) Metformin Extended-Release Micronase Micronized Glyburide Miglitol Nateglinide Novolog Novolog MIX 70/30 Pioglitazone Pioglitazone + Glimepiride Pioglitazone + Metformin Pramlintide Subcutaneous Prandin Precose Repaglinide Rosiglitazone (Avandamet; Avandia) Rosiglitazone + Glimepiride Sitagliptin + Metformin Starlix Symlin Tolazamide (Tolazamide; Tolinase) Tolbutamide Tolinase Diabetes Insipidus – General Information Diabetes Insipidus is certainly not an uncommon medical disorder. Patients of all ages from around the world discover each day that they are suffering from this medical condition. Often abbreviated as DI, this disorder is generally characterized by frequent urination and the excretion of abnormally high amounts of urine. If the patient’s urine is submitted to laboratory analysis, one will find that the urine is highly diluted. Unfortunately, such symptoms do not disappear even if the patient tries to consume lower amounts of fluids. Diabetes Insipidus is actually a disorder that affects the organism’s ability to concentrate urine (the body’s kidneys no longer deal with this situation). It has been determined that DI is triggered by a hormone deficiency. When the patient’s organism does not produce sufficient amounts of vasopressin (ADH) or when the kidneys no longer respond to this hormone, DI appears. When the patient’s medical condition is caused by the inability of his or her kidneys to respond to the release of ADH, the disease is called nephrogenic DI. Another form of this medical issue is known as Central DI. This occurs when the patient’s pituitary gland or hypothalamus are responsible for the disease. Clinical damage to any of these body parts (that may result from infection, surgery, head injury and / or tumor) can easily trigger the hormonal imbalance that causes Diabetes Insipidus. Clinical studies have shown that this medical disorder can also be induced iatrogenically by the intake of diuretics (such as Conivaptan). Diabetes Insipidus – Symptoms Like most other medical conditions, Diabetes Insipidus triggers some specific symptoms that reveal its presence. The most common symptoms include extreme thirst (the patient craves to drink plenty of cold water) and, of course, abnormally frequent urination. Although these symptoms are similar to those that are generally caused by diabetes mellitus (if the patient does not receive an appropriate therapy for his or her medical condition), a specialized health care provider will be able to tell the difference, as the patient who is suffering from Diabetes Insipidus will not experience hyperglycemia (he or she will not present abnormally high blood glucose levels) and his or her urine will not contain any glucose traces in it. Very few patients who suffer from DI complain about blurred vision, as this is an extremely rare symptom. However, patients who do not receive a proper therapy for this medical condition will probably not be able to conserve a sufficient amount of water in their organism. Thus, dehydration symptoms appear with great ease. The patient’s constant need of urinating does not disappear during night-time. Children who are suffering from this medical condition are more prone to developing other symptoms such as abnormal weight changes (weight gain), vomiting, fever, diarrhea, appetite changes, strange eating habits, growth disturbances, and so on. Adults are much luckier from this point of view, as even without the proper treatment for this medical condition, as long as they drink plenty of water in order to offset the amount that is loss through excretion, they might not present any other unpleasant symptoms. If a patient fails to drink a sufficient amount of fluid, his disorder could trigger the following complications: dehydration symptoms (dry mucous membranes, dry skin, fever, weight loss, rapid heart rate, and so on) or electrolyte imbalance signs (lethargy, fatigue, irritability, muscle pain, headache). Diabetes Insipidus – Treatment Clinical studies have shown that both gestational and central DI, effectively react to an appropriate therapy with Desmopressin. However, this therapy method is not recommended in the case of patients who are suffering from dipsogenic Diabetes Insipidus. Unluckily, Desmopressin is also ineffective as a therapy for nephrogenic DI. Patients who suffer from the nephrogenic form of this medical condition have other therapy options. They can start a treatment with other medications such as indomethacin and the hydrochlorothiazide diuretic / water pills (HCT or HCTZ).When a patient develops Diabetes Insipidus, his or her physician will have to try and see what has caused this medical problem. It is important to focus on the therapy for the underlying medical condition as soon as possible, as this will have benefic results on the diabetic disorder as well. Most patients who were suffering from the central form of this medical condition (Diabetes Insipidus) have managed to keep their disorder under control with a medicine called vasopressin (sometimes prescribed as Desmopressin). This medication comes in various forms, as it can be purchased either as tablets (pills) or as a nasal spray. Your personal health care provider will have to determine which of these forms suits you best. In case you develop the unpleasant symptoms of dehydration (which we have pointed out in the previous chapter), we recommend you to start drinking plenty of water in order to replace the fluids that were lost through excretion. The abnormal thirst symptom can be kept under control with the intake of Desmopressin. This medication ought to be taken in a few times per day (at most 3 doses). Patients who suffer from severe dehydration might need to be kept under strict medical supervision in a medical centre. Hospitalization is very useful, as doctors will be able to determine the patient’s exact fluid needs. Furthermore, patients who are suffering from this medical disorder should not forget the importance of keeping their electrolyte imbalance under strict medical supervision. Surgery can also be an option for those who suffer from a severe form of Diabetes Insipidus that has not well responded to the medicine. However, all patients must keep in mind that postoperative treatment is very important. Your physician will give you a prescription with the medicines that you will have to take in after your surgical procedure. The presence of the chronic form of this medical condition does not require any dietary considerations. However, patients who suffer from this disorder ought to take special precautions as their medical condition might interfere with their routine. All patients must be prepared to treat diarrhea and / or vomiting during a long journey and should keep hydrated during hot weather.