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More than 100 million American adults are living with prediabetes or Type 2 Diabetes, according to latest estimates from the Centers for Disease Control and Prevention. But the number of people who know they have diseases which can lead to life - threatening complications, like blindness and heart disease, is far lower. Data from CDC suggest that of estimate 30. 3 million Americans with Type 2 Diabetes, 7. 2 million, or 1 in 4 adults living with the disease, are not aware of it. And among those people living with prediabetes, only 11. 6 percent are aware that they have a disease. Prediabetes is marked by higher than normal blood sugar levels, though not high enough to qualify as Diabetes. Cdc notes that this condition often leads to full - blown Type 2 Diabetes within five years if it's left untreated through diet and lifestyle modifications. Type 2 Diabetes, which is often diagnosed when a person has A1C of at least 7 on two separate occasions, can lead to potentially serious issues, like neuropathy, or nerve damage; vision problems; increased risk of heart Disease; and other Diabetes Complications. Person A1C is two - to three - month average of his or her blood sugar levels. According to Mayo Clinic, doctors may use other tests to diagnose Diabetes. For example, they may conduct a fasting blood glucose test, which is a blood glucose test done after night of fasting. While fasting blood sugar level of less than 100 milligrams per deciliter is normal, one that is between 100 to 125 mg / dL signals prediabetes, and reading that reaches 126 mg / dL on two separate occasions means you have Diabetes. People with full - blown Type 2 Diabetes are not able to use hormone insulin properly, and have what is called insulin resistance. Insulin is necessary for glucose, or sugar, to get from your blood into your cells to be used for energy. When there is not enough insulin or when a hormone doesnt function as it should, glucose accumulates in the blood instead of being used by cells. This sugar accumulation may lead to aforementioned complications. You can help assess your chances of developing Type 2 Diabetes by requesting an A1C test from your doctor, as well as by talking with your family about their health history with disease, as your genetics may influence your risk of Diabetes. Other risk factors of Type 2 Diabetes include obesity, inactivity, old age, personal history of gestational Diabetes, and race, according to Mayo Clinic. For instance, if you are Hispanic, African - American, or Asian - American, you may be at greater risk of Type 2 Diabetes. Nevertheless, you can prevent prediabetes and Type 2 Diabetes by maintaining a healthy weight; following a healthy diet that is rich in whole grains, fruit, vegetables, and lean protein; getting sufficient sleep; and exercising regularly. But preventing disease from progressing if you already have it requires first being able to spot signs and symptoms of Diabetes when they appear.
Also called glycated hemoglobin test, this measures your average blood sugar level for the past 2 or 3 months. You do need to fast or drink anything special for this test. A1c level of 6. 5 or higher shows you have Diabetes. Below 5. 7 is normal. Fasting blood sugar. After you fast overnight, your blood test. Levels higher than 126 mg / dL or higher on two tests show diabetes. Below 100 mg / dL is normal. Oral glucose tolerance. After you fast all night, you give a blood sample both before and 2 hours after you finish sweet drink. Blood sugar levels of more than 200 mg / dL after 2 hours mean you have Diabetes. Less than 140 mg / dL is normal. Random blood sugar. You give blood at random time. A level of 200 mg / dL or higher shows Diabetes. You 'll need these do twice to make a firm diagnosis.
|Central DI (the most common type)||Damage to your pituitary gland or hypothalamus from head injury, surgery, or tumors. This can lead to a lack of ADH.||Synthetic ADH: desmopressin, given by injection, nasal spray, or pill. In mild cases, treatment is increased water intake.|
|Nephrogenic DI||The pituitary releases enough ADH into the body, but your kidneys can't respond to it. This can result from the prescription drug lithium, sickle cell disease, or genetic problems.||Anti-inflammatory medicine (indomethacin); Medications such as water pills (HCTZ and amiloride); Low-sodium diet (if needed); Fluids as needed|
|Dipsogenic DI||Excess fluid intake, caused by a problem with your thirst mechanism, or deliberately drinking too many fluids (may occur with mental illness). This can lead to low blood sodium and possible brain damage.||No known treatment yet except for restricting fluid intake|
|Pregnancy-related DI||A substance made by the placenta that prevents the mother's ADH from working.||Desmopressin (nasal spray or pill)|
Nephrogenic Diabetes insipidus is a disorder of water balance. The body normally balances fluid intake with excretion of fluid in urine. However, people with nephrogenic Diabetes insipidus produce too much urine, which causes them to be excessively thirsty. Affected individuals can quickly become dehydrated if they do not drink enough water, especially in hot weather or when they are sick. Nephrogenic Diabetes insipidus can be either acquired or hereditary. Acquire form is brought on by certain drugs and chronic diseases and can occur at any time during life. Hereditary form is caused by genetic mutations, and its signs and symptoms usually become apparent within the first few months of life. Infants with hereditary nephrogenic Diabetes insipidus may eat poorly and fail to gain weight and grow at the expected rate. They may also be irritable and experience fevers, diarrhea, and vomiting. Recurrent episodes of dehydration can lead to slow growth and delayed development. If the condition is not well - manage, over time it can damage the bladder and kidneys, leading to pain, infections, and kidney failure. With appropriate treatment, affected individuals usually have few complications and a normal lifespan. When nephrogenic Diabetes insipidus results from mutations in AVPR2 gene, condition has an X - link recessive pattern of inheritance. The AVPR2 gene is located on the X chromosome, which is one of two sex chromosomes. In males, one altered copy of gene in each cell is sufficient to cause condition. In females, mutation usually has to occur in both copies of the gene to cause disorder. However, some females who carry single mutated copy of AVPR2 gene have features of nephrogenic Diabetes insipidus, including polyuria and polydipsia. The characteristic of X - link inheritance is that fathers cannot pass X - link traits to their sons. When nephrogenic Diabetes insipidus is caused by mutations in AQP2 gene, it can have either autosomal recessive or, less commonly, autosomal dominant pattern of inheritance. In autosomal recessive inheritance, both copies of gene in each cell have mutations. Parents of individuals with autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. In autosomal dominant inheritance, one mutated copy of AQP2 gene in each cell is sufficient to cause disorder. Healthcare professionals can diagnose person with Diabetes insipidus based on; medical and family history physical exam, urinalysis blood tests, fluid deprivation test, magnetic resonance imaging. Primary treatment for Diabetes insipidus involves drinking enough liquid to prevent dehydration. Health care providers may refer people with Diabetes insipidus to a nephrologist - doctor who specializes in treating kidney problems or to an endocrinologist, doctor who specializes in treating disorders of hormone - producing glands. Treatment for frequent urination or constant thirst depends on the patient's type of Diabetes insipidus: central Diabetes insipidus. A synthetic, or man - make, hormone called desmopressin treats central Diabetes insipidus.
In CDI, symptoms may develop over time or abruptly and may affect individuals of any age. Cdi is characterized by excessive thirst and excessive urination, even at night. The severity and progression of CDI varies from case to case. Some individuals may have severe form of disorder with little or no vasopressin activity. Others may have mild form of disorder with residual vasopressin activity. Without appropriate AVP secretion, individuals with central diabetes insipidus are unable to concentrate urine by reabsorbing water in kidneys. This results in obligatory excessive urine output of dilute urine. Consequently, individuals must drink excessively to prevent dehydration. In response to thirst, affected individuals may drink several gallons of water a day. If affected individuals are deprived of water for an extended period of time, rapid dehydration will occur. Thirst cravings can be strong enough to awaken people from sleep. In infants, additional symptoms may occur, including irritability, lethargy, vomiting, constipation and fever. If left untreated, repeat episodes of dehydration can potentially result in seizures, brain damage, developmental delays, and physical and mental retardation. However, with proper diagnosis and prompt treatment, intelligence and development is usually normal unless more global problems in development of the brain are associate. Affected children may develop bedwetting, fatigue, weight loss, and growth retardation. Individuals with CDI are at risk of developing dehydration and cardiovascular symptoms including irregular heartbeats, fever, dry skin and mucous membranes, confusion, seizures, change in consciousness, and potentially coma. Affect adults may develop orthostatic hypotension, condition in which there is a dramatic decrease in blood pressure upon standing or sitting. Orthostatic hypotension can result in dizziness or momentary loss of consciousness.
Diagnosis of CDI may be suspect based upon identification of characteristic findings, specifically Excessive thirst and Excessive urination. Thorough clinical evaluation, detailed patient history, and a variety of specialized tests may be used to confirm diagnosis. Physicians may take blood and urine samples to determine the concentration of salts, and sugar within those samples. The ratio of these substances to water within blood or urine is known as osmolality. Individuals with CDI have high osmolality in their blood and low osmolality in their urine. Urine osmolality may be estimated by specific gravity, which is low in untreated diabetes insipidus. Additional tests may be necessary to confirm diagnosis or rule out other causes of diabetes insipidus. Assay of vasopressin in circulation is problematic since it is unstable and has a short half - life. Copeptin is cosecreted with vasopressin and is more stable. Therefore, it provides surrogate marker of vasopressin secretion. Affected individuals may also receive diagnostic injection of hormone arginine vasopressin or analogue of vasopressin such as DDAVP to determine kidney response. Individuals with different forms of diabetes insipidus do not respond to vasopressin supplementation because in NDI kidneys are resistant to the effects of vasopressin. Conversely, individuals with CDI respond to supplemental vasopressin treatment. In some individuals, additional test, known as water deprivation test, may be required to confirm diagnosis. During this test, affected individuals cannot ingest any fluids and can only eat dry foods for a specific period of time. Blood and urine samples will be taken to measure serum sodium concentration or osmolality and urine output, osmolality or specific gravity. This dehydration provides stimulus for vasopressin secretion which can be estimated by measuring copeptin concentrations or by concentration of urine. Serum vasopressin levels may be measured as well if handled appropriately. Body weight and vital signs are monitored to prevent excessive dehydration. This test may be used to distinguish between various causes of diabetes insipidus. Some individuals will have x - ray scans including computed tomography or magnetic resonance imaging to rule out brain tumors that can affect the pituitary gland, potential cause of CDI. A common finding in MRI in children with central diabetes insipidus is absence of bright spot in posterior sella which is normally thought to represent vasopressin containing neurons.
The effect of neuropathy on the bladder consists of a triad of changes. First of all, reduction of sensitivity in the bladder. This basically means that you will not sense bladder filling in the same way, resulting in infrequent visits to the toilet with aim of void. Secondly, as a consequence of this, bladder volumes will increase - since you will not sense / notice that you need to void. Perhaps you will just go to the toilet once or twice per day? Thirdly, you will have impaired bladder contractility - making it impossible to empty your bladder completely. This results in retention, urinary tract infections, incontinence and, in the long run, increased risk of kidney failure. So these changes lead to magnify, - contractile, hypotonic bladder that initially does not need to give so many symptoms. But when the sphincter also becomes affected, it can lead to urinary retention, incontinence and repeat urinary tract infections. Some people also have bladder pareses with painful chronic urinary retention. You can also find additional information in our enCATHopedia Leaflet.
All of this may seem rather discouraging to someone who has developed diabetic bladder, but fortunately there is treatment for the condition. Quite simply, bladder must be empty regularly and completely, allowing it chance to recover and to return to normal function. Most of the time, this is possible, but it may take some effort. Keeping in mind that every situation is different, sample treatment plan for someone with a severely distended and poorly - emptying bladder might begin with placement of a Foley catheter. This is a tube inserted into the bladder that drains into bag tap to leg. This bag can be emptied as needed and the catheter is left in for five to seven days to allow the bladder to drain and for bladder muscles to regroup. When Foley catheter is remove, next step is self - catheterizing inserting the catheter yourself when your bladder needs to be empty, and removing it afterward. This may seem intimidating, but it is usually easier than fear, and also usually more comfortable than having a full - time catheter in place. People new to self - catheterization may also worry about contracting infection, but there is less risk of infection with self - catheterization than there is with full - time Foley catheter. In fact, whenever possible, it is ideal to skip the first step entirely and go directly to self - catheterization, but not everyone is psychologically up to this challenge at first. Once youre self - catheterizing, you must follow a strict schedule of attempting to empty your bladder no less frequently than every three to four hours from the time you wake up until you go to bed at night. This is called timed voiding. The key is that you must attempt voiding, whether or not you feel any urge to go. Another good idea is to double - void, or to empty your bladder, leave the bathroom and go about normal activities for 10 - 15 minutes, and then return and attempt to void a second time. People are usually surprised that they are often able to pass more urine, even when they think they had void completely short time before. After the second attempt, self - catheterize, measuring the amount of catheterized urine and recording the amount in log. Then, three or four hours later, repeat process. There is no need to set an alarm to wake you up to void and catheterize during the night, but if you do wake up feeling like you need to go, catheterize to ensure complete emptying. As your bladder recovers, you may be able to self - catheterize less frequently. In general, if one or more of your daily catheterizations consistently yield less than 100 cc, then it is safe to cut back to four times a day, then three times a day, and so on. With time, you may be able to get down to single catheterization at bedtime, then perhaps every other day, then once a week. In most people, bladder eventually recovers, and catheterization can be eliminated entirely.
Most people typically urinate four to eight times a day. Needing to go more than eight times a day or waking up at night to go to the bathroom more than once at night is considered frequent urination. Though the bladder can often hold as much as 600 ml of urine, urge to urinate is usually felt when the bladder contains about 150 ml of urine. There are two different ways to look at frequent urination: either as an increase in total volume of urine produced or dysfunction in storage and emptying of urine.
Diabetes and urologic diseases are very common health problems that markedly increase in prevalence and incidence with advancing age. Diabetes is associated with earlier onset and increased severity of urologic diseases, resulting in costly and debilitating urologic complications. Urologic complications, including bladder dysfunction, sexual and erectile dysfunction, as well as urinary tract infections, have a profound effect on the quality of life of men and women with Diabetes. This review presents a comprehensive overview of current understanding of clinical and basic research on urologic Complications of Diabetes and recommendations for future directions for research and clinical care.
Burning When You urinate. Frequent urge to urinate. Pain in your back or abdomen. Do any of these symptoms sound familiar? These are all symptoms of urinary tract infection, or UTI, for short. Studies show that people with Type 2 Diabetes have a greater risk of getting UTI than people without Diabetes. Despite the fact that UTIs are common, they can also lead to more serious situations if theyre not caught and treat. Disclaimer of Medical Advice: You understand that blog posts and comments to such blog posts do not constitute Medical Advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. Opinions and other information contained in blog posts and comments do not reflect the opinions or positions of the Site Proprietor.
If you or someone you are caring for has diabetes, call doctor if you notice these symptoms: frequent and strong urge to pee pain, burning feeling or discomfort when peeing urine that has strong smell, cloudy, dark or bloody pain in the back and / or lower abdomen, fever or chills note that you do not have to have all of these symptoms, and symptoms can be different in different people. For example, in some elderly patients, UTI can also present as dementia, increase dementia or agitation. Some diabetes patients, especially those with diabetic neuropathy, may not experience the same pain in the abdomen or back when they have UTI.
Taking care of your diabetes well will help prevent UTIs. For example, having high blood glucose levels can increase your risk of UTI, so keeping blood sugar levels as steady as possible is important. Make sure you empty as much of your bladder as possible when you pee. This can be an issue for people with diabetes and can contribute to bacteria growth that can cause infection. Other UTI Prevention tips are the same whether you have diabetes or not. They include: drinking plenty of water. Do not pee you have to go, find a bathroom and go. Wipe front to back after going to the bathroom. Wear cotton underwear. For more prevention tips and information, read UTI Prevention on our blog. With diabetes and UTIs, it is key to keep regular appointments with your doctor and always ask questions about how you can best care for yourself. Ask your doctor to explain how to best prevent and quickly recognize UTIs. If your doctor diagnoses you with UTI and prescribes antibiotics, ask if you can take Uristat tablets to help relieve pain. Its main ingredient is phenazopyridine HCl. Mention this to your doctor, especially if you know you have kidney problems or other diabetes complications. If you have friends or loved ones with diabetes, share this article with them.
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