Central non-bloody diabetes is a recent announcement about diagnostics and treatment. Diabetes mellitus symptoms in women and diseases of diabetic diabetics

RCHRH (Republican Center for Development of Health Protection of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical protocols of the Ministry of Health of the Republic of Kazakhstan - 2013

non-bloody diabet(E23.2)

endocrinology

General information

Short description

hardened

protocol of the expert committee

food development, protect health of the Ministry of Health of the Republic of Kazakhstan

non-bloody diabet(ND) (lat.Diabetes insipidus) - enlightened, degraded synthesis, secretion, or even vasopressin, which appears as an extraordinary great number of cuts from low salt polymeric
Epidemiology . The prevalence of ND in young populations varies from 0.004% to 0.01%. The light tendency is indicated until the growth of the width of the ND, the sprout, for the rakhunok of the central form, is used to knit with the advances of the number prompt engagement It is carried out on the brain, as well as cases of craniocerebral injuries, in case of such drops, the ND development is close to 30%. Vvazhaєya, scho ND, however, often suffers from both women and men. The peak of sickness falls on 20-30 years.

Name of the protocol:non-bloody diabet

Code (codi) according to ICD-10:
E23.2 - Non-blood diabetes

Date of release to the protocol: April 2013 rock.

Fast, as vikoristoyutsya in the protocol:
ND - non-bloody diabetes
PP - primary polydipsia
MRI - magnetic resonance imaging
AT - arterial vise
SD - cukroviy diabet
UZD - ultrasound doslіgennya
Shlunkovo-intestinal tract - shlunkovo-intestinal tract
Refinery - non-steroidal prototypes
CMV - cytomegalovirus

Category of patients: children and women from 20 to 30 years of age, a history of trauma, neurosurgical involvement, pukhlin (craniopharyngoma, germinoma, gloma, etc.), infectious diseases (congenital CMV-infection)

Coristas to the protocol: clinical therapist, doctor-endocrinologist of the polyclinic about the hospital, neurosurgeon to the hospital, traumatologist of the hospital, medical pediatrician.

Classification

CLINIC CLASSIFICATION:
Naybils are often encountered:
1. Central (hypothalamic, hypophyseal), accumulation of impaired synthesis and secretion of vasopressin.
2. Nephrogenic (nirkovy, vasopresin - resistant), characterized by nirok resistance to vasopresin.
3. Primary polydipsia: collapse, if pathological sagging (dipsogenic polydipsia) or compulsive pity (psychogenic polydipsia) and due to a lack of overwhelming water and symptom-related symptoms, the result is no longer red diabetes When the body dehydrates, the synthesis of vasopressin is renewed.

Also see and are born type of diabetics:
1. Gestagenium, dressings with an increase in the activity of the placenta enzyme - argininaminopeptidazi, ruinu vasopresin. When the situation is flat, the situation is normalized.
2. Functional: in children of the first fate of life and understanding of the immaturity of the concentration mechanism of low and increased activity of phosphodiesterase type 5, so that it can lead to the rapid deactivation of the triple receptor to low vasopressin.
3. Iatrogenic: stagnation of diuretics.

Classification of ND according to the importance of overload:
1. easy form- seeing up to 6-8 l / day without treatment;
2. middle - see section up to 8-14 l / day without treatment;
3. Important - seeing more than 14 liters / day without treatment.

Classification of ND by the level of compensation:
1.compensation - do not turbulent when spraga and polyuria are detected;
2. subcompensation - in case of lіkuvannі it is thrown at the time of the day;
3. decompensation - spraga and polyuria are taken.

diagnostics

Switching of the main and additional diagnostic entries:
Check in before the scheduled hospitalization:
- Zagalny analysis of the slaughter;
- biochemical analysis of blood (calories, sodium, calciferous calcium, calcium ionization, glucose, blood sugar, sechovina, creatinine, blood osmolality);
- assessment of dyuresis (> 40 ml / kg / day,> 2l / m2 / day, section osmolality, relative density).

Basic diagnostics come in:
- Sample with dry food (dehydration test);
- Test with desmopresin;
- MRI of the hypothalamic-hypophyseal zone

Dodatkovі diagnostics enter:
- ultrasound nirok;
- Dynamic test will become a function of nirok

Diagnostic criteria:
Skargi and anamnesis:
The main manifestations of ND are polyuria (seeing more than 2l / m2 for more or 40 ml / kg for dob for older children and adults), polydips (3-18l / dob) and related sleep disturbance with them. Characteristically, the transition of simple cold / kryzhano water. It can be dryness of shkiri and slimy, change in saliva and sweat. Appetite, as a rule, decreases. The variability of symptoms lie at the level of neurosecretory deficiency. In case of partial deficiency of vasopressin, clinical symptoms may not be very viral and manifest in the minds of nutritional deprivation or overwhelming loss of ridin. When taking an anamnesis, it is necessary to clarify the triviality and severity of symptoms in patients, the manifestation of symptoms in polydipsia, polyuriasis, diabetes in relatives, a history of trauma, neurosurgery, etc. , toxoplasmosis, encephalitis, meningit).
Newborns are not happy with the basic picture of being ill. In such patients, it is possible to prevent the loss of oil, dry and blida shkira, The visibility of the sleep and the visibility, the adjustment of the temperature of the room. The stench can cause water to pass through breast milk, and sometimes it becomes symptomatic only when the baby is seen from the breasts. The osmolality of the slice is low and rarely changes at 150-200 mosmol / kg, but the polyuria is only in the case of a child's birth. Children have such early vik even more often and rapidly develop hypernatrium and hyperosmolality of blood with sudomas and coma.
In older children, on the first plan in the clinical symptomatology, there may be symptoms of sprague and polyuria; Children grow badly and gain vagu, they often have bloating when they get sick, they have an appetite, they tend to suffer from hypotonic stun, constipate, get clogged psycho development... Obvious hypertonic dehydration of the wine only at the time of day access to the country.

Physical details:
When you look around, you can see symptoms of dehydration: dryness of the skin and mucous membranes. The systolic AT is normal, or there are trochais of reductions, the diastolic arterial grip of displacement.

Laboratory Doslidzhennya:
For tribute extravagant analysis Sechі - won’t be bad, do not take revenge on any pathological elements, with a low tolerance (1,000-1,005).
A test is carried out behind Zimnitskiy to determine the concentration of buildings. If in any case of a pitoma of a slice of 1.010, then the diagnosis of ND can be made, a protest of memory, the presence of a pitom in a slice and a bottle of a pitom of a slice.
Plasma hyperosmolality - at 300 mosmol / kg. At normal, the osmolality of plasmas becomes 280-290 mosmol / kg.
The hypo-osmolality of the section (less than 300 mosmol / kg).
Hypernatrium (more than 155 meq / l).
In the case of the central form of ND, a decrease in the level of vasopressin in the blood is indicated, and in the case of nephrogenic form, in the norm, or even if there is no change.
dehydration test(Dry food test). Dehydration test protocol according to G.I. Robertson (2001).
Dehydration phase:
- taking shelter for osmolality and sodium (1)
- I am grabbing a swearing and osmolality (2)
- vimiryati vagu of the patient (3)
- control of arterial vise and pulse (4)
Nadal in equal intervals of an hour in the fallowness from the patient's camp in 1 or 2 years, or repeat points 1-4.
Patients are not allowed to drink, but they are also bridged, at least during the first 8 years of the test; When she was bathing, she was not guilty of revenge of being richly driven and easily consumed in carbohydrates; perevazhnі boiled eggs, grain bread, low-fat varieties of meat, ribi.
Try to lean back at times:
- consume more than 5% oil
- unbearable jade
- an observationally important patient
- adjustment of blood sodium and osmolality between norms.

Desmopresin test... The test is carried out immediately after the end of the dehydration test, if the maximum capacity of the secretion / endogenous vasopressin is reached. The patient is given 0.1 mg of tableted desmopressin before re-absorption or 10 mcg intranasally in a spray. The osmolality of the section changes to the intake of desmopresin after 2 or 4 years after. In the course of the test, the patient is allowed to drink, but not more than 1.5 times the volume of this video, on the dehydration test.
Interpretation of the results in the test with desmopressin: Normally, in case of primary polydipsia, the concentration of blood is 600-700 mosmol / kg, the osmolality of the blood and sodium is lost in the normal range, self-indulgence. Desmopressin practically does not increase the osmolality of the section, since the maximum concentration is already reached.
With central ND, the osmolality of the blood in the course of dehydration does not outweigh the osmolality of the blood; With the introduction of desmopresin, the osmolality of the section increases by 50% more. In case of nephrogenic ND, the osmolality of the blood and sodium to move, the osmolality of the cross section is less than 300 mosmol / kg yak, and with the central ND, if the osmolality of the cross section is not practically moved up to 50% if it is vicious with desmopresin.
Interpretation of the results of samples is summarized in tab. ...


Instrumental doslіgennya:
Central ND is used as a marker of the pathology of the hypothalamic-hypophysis region. MRI of the brain є using the vibor method for diagnostics of the hypothalamic-hypophysis region. With central ND, the method is low overvag in the case of CT scans and other methods of visualization.
MRI of the brain is indicated for detecting the causes of central ND (puffiness, inflammatory disease, granulomatous disease of hypothalamus and hypophysis, etc.) pathological changes for MRI data, it is recommended to carry out a complete follow-up in dynamism, as it is not easy to trample, if the central ND appears for a few rocks before the appearance of puffin

Shown for consulting fahivts:
With an adolescence for the manifestation of pathological changes in the hypothalamic-hypophysis region, consultations of a neurosurgeon and an ophthalmologist are indicated. In case of revealed pathology of the secular system - a urologist, and in case of a confirmed psychogenic variant of polydipsia, it is necessary to refer to a consultation before a psychiatrist or a neuropsychiatrist.

Differential diagnosis

It is carried out between three main stanes, which are supported by hypotonic polyuria: central ND, nephrogenic ND and primary polydipsia. Differential diagnosis is based on 3 main stages.

Likuvannya beyond the cordon

Take a lykuvannya in Korea, Izrail, Nimechchin, USA

Otrimati the consultation on medturism

lykuvannya

Cіlі lіkuvannya:
The change in the turn of the sprague and polyuria to such a world, as it allowed the patients to lead a normal way of life.

Likuvannya tactics:
Central ND.
Desmopressin is the preferred drug. More patients have to prescribe desmopressin in tablets (0.1 and 0.2 mg each), if they want to continue successfully using desmopressin intranasal spray. I will look at individual pharmacokinetic features in the region, it is important to start the triviality of a single dose of the drug individually in a skin patient.
Desmopresin therapy in the form of tablets is indicated in a cob dose of 0.1 mg 2-3 times in the middle 30-40 minutes before or after 2 years. The average dose of the drug is varied from 0.1 mg to 1.6 mg per dose. One-hour reception of їzhі can reduce the level of moisture from the shlunkovo-intestinal tract by 40%. When intranasal zastosuvanny pochatkova dose to become 10 mcg. When sprinkling the spray, it spreads along the front surface of the mucous nasal emptying, which will prevent a greater concentration of the drug in the blood. The need for the preparation is varied from 10 to 40 mcg for dobu.
The main meta liquefaction with desmopressin is the addition of a minimally effective dose of a drug for the suppression of sprague and polyuria. Do not look at the nature of the therapy for the adjustment of this kind of slaughter, especially in the skin analysis for the analysis of the slaughter for Zimnitskiy, though not all the patients from the central ND in the same class normal indicators concentrated function of nirok (physiological variability of concentration throughout the day, concomitant pathology nirok and іn.).
Non-bloody diabetics with inadequate spragoy.
With a change in the functional center of the sprague towards the lowering of the threshold of sensitivity, hyperpsy, the patient is sick to the development of such an accelerated therapy with desmopressin as water poisoning, which is potentially life-threatening. Such patients are periodically advised to pass the medication in order to see the overwhelmed excess of age or fixation of the medication.
Stan of Adipsia with central ND can be manifested in cases of epizodes of the hypothesis of hypernatria. The conduct of such children will come with a fixed communication with a child, or with recommendations to take a child for a whole lot of pictures + 200-300 ml of a child. Patients in the loss of a sprague need a special dynamic control to become more powerful, and in some cases, more often, based on osmolality and sodium blood.

Central ND for surgical interventions on hypothalamus or hypophysis due to head injuries.
Ingestion in 75% of cases is transient, and in 3-5% - triphasic extension (I phase (5-7 days) - central ND, II phase (7-10 days) - syndrome of inadequate secretion of vasopressin, III phase - persistent central ND ). Desmopresin is indicated for the manifestation of symptoms of non-congenital diabetes (polydipsia, polyuria, hypernatria, blood hyperosmolality) at a dose of 0.05-0.1 mg 2-3 times as needed. Skin 1-3 days to assess the need for the drug: to skip the Chergov dose, to control the renewal of symptoms of non-diabetic diabetes.
Nephrogenic ND.
For the reduction of symptomatic polyuria, thiazide diuretics and low sodium intake are used. Antidiuretic effect in this type of reasoning to quick obstetric problems after a child's life, to a decrease in glomerular filtration rate, to a decrease in water reabsorption and sodium from the primary canal in the proximal However, until recently it was shown that thiazide diuretics can increase the number of aquoporin-2 molecules on the membranes of the epithelial cells of the nephron channels, just like vasopresin. At the same time, there is no reason to waste a lot of time to improve your life, or the signs of high blood pressure.
When endomethacin is detected, additional velmi are developed with a friendly effect, however, the refinery can provoke development of two-fingered intestinesі shlunkovo-intestinal bleeding.

Non-drug treatment:
With the central ND z normal function to the center of sprague - a great nutritional regime, the day is very special. If there is a deterioration in the function to the center of the sprague: In case of nephrogenic ND - intercourse salts, implantation of products, rich calories.

Drug treatment:
Minirin, tablets of 100, 200 mcg
Minirin, oral lyophilisate 60, 120, 240 mcg
Preynex, nasal spray, 10mcg / dose
Triampur-compositum 25 / 12.5 mg tablets
Indomethacin - tablets, in a intestinal corrosive shell of 25 mg

Інші vidi lіkuvannya: -

Hirurgicne involvement: When newly approved hypothalamic-hypophyseal region.

Prophylactic come in: do not see

Further information: outpatient care

Indicators of the effectiveness of treatment and safety of methods of diagnosis and treatment, described in the protocol: Change in sprague and polyuria.

1. List of victorious literature: 1. Methodical recommendations ed ed. Didova I.I., Melnichenko G.A. "Central non-blood diabetics: differential diagnosisі lіkuvannya ", Moscow, 2010 36 pages. 2. Melnichenko G.А., V.S. Pronin, Romantsova T.I. that in. - "Clinic and diagnostics of hypothalamic-hypophyseal illnesses", Moscow, 2005r., 104 side. 3. Endocrinology: national curriculum, ed. Didova І.І., Melnichenko GA, Moscow, GEOTAR-Media, 2008, 1072 p. 4. Pigarova EA - Non-fertile diabetics: epidemiology, clinical symptoms, go to lykuvannya, - "Doctor.ru", No. 6, part II, 2009r. 5. Practical endocrinology / ed. Melnichenko G.A.-Moscow, "Practical Medicine", 2009r., 352 p. 6. Neuroendocrinology / Genri M. Cronenberg, ShlomoMelmed, Kenneth S. Polonsky, P. Rid Larsen, translated from English. Pid ed. Didova І.І., Melnichenko G.A., Moscow, "RidElsіver", 2010, 472 p.

information

List of publications:
1. Danyarova LB - Candidate of Medical Sciences, a specialist in endocrinology of NDI cardiology and internal ailments, a doctor-endocrinologist of the highest category.
2. Shiman J.J. - a young scientist in science in the field of endocrinology NDI cardiology and internal ailments, doctor-endocrinologist.

Ordering for the presence of a conflict of interest:Відсутнє.

reviewer: Erdesova K.Є. - Candidate of Medical Sciences, Professor, Department of Internship KazNMU.

Letting the minds look at the protocol: The revision of the protocol is not carried out earlier, at least 1 time in 5 years, or if new data are appropriate for the diagnosis and treatment of inconvenient illness, I will become a syndrome.

Attached files

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Lack of blood diabetes is a pathology, as a result of a lack of vasopressin, or an absolute abnormal deficiency.

Vasopresin (antidiuretic hormone) is secreted in the hypothalamus and other functions, leading to the normalization of the secular process. According to the reasons for this, there are three types of ailments: genetic, addiction, idiopathic.

There are a lot of ailments who are suffering from birthright, I still don't know exact reason yogo viniknennya. Such an unclean diabetic is called "idiopathic" and is called by almost 70% of the sick. Genetic non-congenital diabetics of vicissitudes with a creep factor. In such a way, the presence of some of the members of the family, for the decile generation of sleep, is in the presence of some members of the family.

wideness

Non-blooded diabetics develop in an arbitrary manner. For example, in Uzbekistan as a whole, according to the republic, in 2012, with such a diagnosis, 2295 children were transferred to the oblast, including 235 children. On the skin 100 yew. In 2012, the number of people in the entire population of the republic fell to 7.7 individuals with this diagnosis. The majority of ailments in the country in Bulo in 40 - 49 years - 530 individuals (22.9%). Children and children in Uzbekistan are ill at ease - in 2012, there were 2.7 children per 100 yew. Childish population of the republic.

cause development

Approximately in 30% of cases the cause of unhealthy diabetes is so unimportant. It’s tied together, but whether diagnostics were not carried out, the stench didn’t show any ailments, but bureaucrats, which could serve as the reason for the development of ailments.

The development of central non-bloody diabetes is characterized by a deteriorated ADH secretion. It’s worth trying to get rid of the fact that there is a lack of vasopresin in the hypothalamus, but industrial widdil The brain is suspected of the synthesis of ADH and the robotic function. The reasons for becoming ill can be nasty factors:

• fluff to the brain;
• head injuries;
• quick operation (brain surgery);
• syphilis;
• sarcoidosis;
• encephalitis;
• a lot of weight loss for swelling, leg and breasts;
• ailments nirok;
• anemia (sickle-cell);
• congenital pathology;
• nirkova lack of;
• implantation of medications, which are toxicly injected on the nirki;
• imbalance of calcium and calcium in the blood;
• polycystosis;
• amiloidosis;
• ushkogennya of cerebral speech.

With the development of nirkovy non-blooming diabetes, the ailment is opposed in a vortex order: the organism of viroblyaє vasopresin is at a sufficient level, protein tissues do not give rise to new reactions.

Central non-bloody diabetes

The development of the central or hypothalamic-hypophyseal non-unguarded diabetics goes through the lack of nyrok until the accumulation of birth. Given pathology winery has a history of porosity, which can be found in the functions of the distal tubules of the nephron. As a result of ailments with a common form of uncrowded diabetics, we will accelerate those who suffer in the complex with polydipsia (tobto, nevgamovny spragi syndrome).

Slide to respect that if ailments have the power of unbounded living of water, then there will be no threats for them. Just as there is a possibility for quiet reasons for the day, and illnesses cannot be spared at all times, at a new stage the development of anxiety (or hyperosmolar dehydration) can be quickly started. Reaching the extreme stage given to the syndromeє not unbearable for the life of a sick person, for that, as a small stage, the age passed into a hypersomolar coma.

Trivial relocation of the central noncautious diabetes for a patient overgrowing into a nirku insensitivity is often introduced piece by piece into for drinking purposes antidiuretic hormone. For a reason, which sooner think of the love of the formation of a non-bloody diabetes, Tim, apparently, a more friendly character, will fill the predictions of a sick person.

Likewise, it’s worth respecting that the signs of obsigation when we live ailments may be the reason for the appearance of such supportive ailments, such as dyskinesia of zhivchnyh shlakhiv, the development of a syndrome of ruptured intestines and descent of slurry.

Nirkovy non-bloody diabet

The infection of non-uterine diabetes in this form is provoked by organic or receptor pathologies of nirok, including an enzymatic enzyme. The form to finish the rіdkіsna, and if it is denoted in children, then, as a rule, in the whole type of vona ma vrodzheniy character. Victims of mutations in the gene of aquaporins-2 or mutations of the receptor for vasopresin.

As soon as I’m talking about the trick of the form when the grown-ups become ill, then there is a lack of deficiency in the reasons, as the provocation is given to the form of diabetes, and not only because of the peculiarities of the ethology. In addition to being diagnosed with nircovy, uncautious diabetics, there may have been trials of therapies carried out with medications in the past and other specific analogs.

Idiopathic non-congenital diabetes

The incidence of non-hygienic diabetes in its most form becomes a third of all types of diabetes. Here we see a picture of the visibility in the process of diagnostics of hypophysis of any kind of organ pathology. In other words, the frequency of incapacitation of unclean diabetics is indicated. Deyakim vipadk can have a transfer of downturn.

symptoms

The earliest acquaintance of a non-bloody diabetes є polyuria - an increase in deiuresis. In the middle of the year, the ailments are encouraged to increase the rate of up to five or six years for dobu. Have a good time until the next night. When interconnected by the reception of water, the sick person will lose his temper: head bill, Frequent sertsebitty, decrease arterial vise, Likhomanka, blues, psychomotor zbujennya.

On the other side of the world, the line is the compensatory polydipsia - sprague. Moreover, it is characteristic that the sprag is thrown in only after the help of the cool water. In addition, the dryness of the skin and mucous membranes, as well as a decrease in saliva and sweatiness, are prevented.

At nemovlyat clinical symptoms appear as such in older adults. The price is tied with this, but with the presence of sprague, the child cannot possibly be attributed to it, and it means that the mother cannot be re-introduced into the new world. Children have the following symptoms:

1. Vrata massi tila;
2. Covering the development;
3. Blindness of small curves;
4. Appetite visibility;
5. Visibility of tears and sweat;
6. blues;
7. Increased temperature.

Symptoms of non-bloody diabetes in choloviks є decreased muscle cravings and potency.

Symptoms of non-bloody diabetes in women: menstrual cycle right up to amenorrhea, tied up with cymus without pregnancy, but at times, if the vagina nevertheless came, there was an increase in the risk of abortion.

Beastly respect: in children of early age, hypernatremia and hyperosmolarity of blood quickly develop on the basis of cold weather, which is supervised by the appearance of the court and development of the Komi.

diagnostics

If you are susceptible to non-congenital diabetes, you need to go to an endocrinologist. Patients are presumed to see a neurosurgeon, neuropathologist, ophthalmologist. Women are guilty of the advice of a gynecologist.

You will need to go through the deyakі prelіjennya. Schob viyaviti non-Ukrainian diabet:

1. I will slaughter and shelter a sick person afterwards;
2. Vykonuyut test Zimnitsky;
3. Varying ultrasound nirok;
4. Conduct CT or MRI of the brain, echoencephalography.

Laboratory analyzes allow assessing the osmolarity of the blood, the uniformity and the osmolarity of the blood. Biochemical analysis of blood, so you can read data about glucose levels, nitrogen, calories, sodium and other words.

Diagnostic indicators of ailment:

• Low cross section osmolarity (less than 100-200 mosm / kg);
• High amount of sodium in the blood (from 155 meq / l);
• Decreased the size of the section (less than 1010);
• The osmolarity of the blood plasma was adjusted (as of 290 mosm / kg).

Childish and childish diabetes is easy to develop. In the first vipad in the patient's section, zukor does not appear, the level of glucose in the blood does not change the norm. The code for getting caught according to ICD-10 is E23.2.

The main pathological states, as a result of the development of neurogenic non-congenital diabetes, are:

• psychogenic polydipsia;
• chronic nirkova lack;
• Diabetes mellitus;
• nephrogenic non-congenital diabetes.

Differential diagnosis

Sleepy symptoms for unhealthy diabetes and psychogenic polydipsia є spraga and part of the disease. However, psychogenic polydipsia does not develop in a rapist manner, but in deeds, when a sick person is sick (so, so, it’s not a matter of being fooled by women themselves). In case of psychogenic polydipsis, there are signs of thickening of blood, symptoms of dehydration do not develop in the case of a test with intercourse of the family: the generality of the vision decreases, and the degree of the old age is greater.

chronic nirkova lack so can suprovodzhuvati sprague and ryasny dyures. However, such a camp can also be susceptible to the appearance of sectoral syndrome (it appears in the section of blood cells, leukocytes and erythrocytes, but not to be supervised by any symptomatology) and high diastolic (in the people). Moreover, with a nircovian lack of visibility, there is an increase in the blood of the family and creatine, as in case of non-vivid diabetes, it is found in between the norms.

In case of diabetic diabetic, a high level of glucose appears in the blood, in addition, the relative importance of the section is determined and glucose is indicated (the vision of glucose from the section).

Nephrogenic non-congenital diabetes by key manifestations similar to the central form: strong spraga, parts of the lump of ailment, signs of thickening of blood and dehydration, low pitoma of the whale - all tied to these and other forms of ailment. Peripheral form normal or abnormal adjustments antidiuretic hormone (vasopresin) in the blood. In addition, in this case, there is an overall effect of specific drugs, which is the reason for the peripheral form є insensibility of receptors in the cells of the nerve tubules to ADH.

Yak lіkuvati non-ugly diabetics?

In the basis of the treatment of non-bloody diabetes, therapy with synthetic analogs of vasopresin is substituted. Before the drugs, which compensate for the level of antidiuretic hormone in the body, take Desmopressin or Adiuretin. The stench is dispensed in the form of tablets or nasal sprays. In patients with diabetics who are pills with desmopresin, the dosage is up to 0.4 mg 3-4 times a day. Injection in nіs rіdini with synthetic vasopressin can also be carried out at least 3 times for dobu.

In the case of non-bloody diabetics, there are also medications with a more trivial effect of the diabetic, for example, pitressin Tanat. Yogo can be consumed once every 3-5 dB. An important role in the development of non-bloody diabetics is the development of diethotherapy. All ailments with a deficiency of anti-diuretic hormone in the body are recommended to alternately eat and drink a quantity of foldable carbohydrates in the race (potatoes, vegetables, grains, beans, meat, chives).

Stimulation of natural vasopressin viroblast in case of non-congenital diabetes mellitus is carried out with Chlorpropamide and Carbomazepin preparations.

Patients with chubby hypophysis are shown surgical treatment non-bloody diabetes - a visible swelling and, in times of need, radioactive optimization.

Diet and kharchuvannya

Basically, the development of the therapy is the price of changing the severance, and in addition, replenishing the body with stocks of vitamins and minerals, as the stench "consumes" in conjunction with frequent poses in the toilet.

Varto viddavati perevagu prepared itself in the following ways:

• vidvaryuvati;
• for a couple;
• extinguish the products in the stewpan z olive olivesі water;
• zapіkati in the spirit, bazhano in the sleeves, for the preservation of all the corny speeches;
• in multivarts, in the "grease" mode.

If people have a poor diabetic child, they are guilty of the inclusion of these categories of products, which can help sprague, for example, malt, greased herbs, spices and spices, alcohol.

Dieta primed on the following principles:

• a decrease in the amount of alcohol consumed, exceeding the norm in carbohydrates and fat;
• change the concentration of salt, reducing the amount of living up to 5 g for doba;
• harvesting can be folded over from vegetables and fruits;
• for vtamuvannya spragi vikoristovuvati natural juices, fruit drinks and compotes;
• live only meat;
• include in the race riba and seafood, eggs;
• accept rib fatі phosphorus;
• harchuvatisya often in small portions.

Zrazkov menu for the day:

• first snack - omelet (steamed) for 1.5 eggs, vinegret (for rose oil), tea with lemon;
• other snidanok - baked apples, sour;
• obid - soup with vegetables, meat vidvarne, beet stewed, lemon drink;
• poludenok - vidvar shipshini, boiled dumplings;
• supper - riba vidvarna, potato vidvarna, sour cream, tea with lemon.

Ryasne pittya is necessary - even the body is involved in a lot of water during dehydration and it needs to be compensated.

people's funds

For a better sleep and a decrease in energy consumption, it’s worthwhile to get back to sleep:

1. Look in the rural parts of the cultivation of valerian roots, fruit of fennel and cumin, grass of the willow, and mix everything up and down. Then take two tablespoons of syruin from the otriman sumy and pour 400 ml of sprinkle, let it brew until cold and dry. Take on a drink with a jarring or nervous anxiety.
2. Look in the rural parts of the cultivation of valerian roots, hop cones, herb poultry, the fruit of the shipshini, leaves the meat and mix everything up. Take out one tablespoon of syruin with a small amount and pour a bottle of sprinkle. Let it brew for a year, and then sit. Take 1/3 of the flask for a night in case of sleeplessness or increased nervous anxiety.

To change the sprague:

1. Take 60 grams of ripened burdock root, put in a thermos and pour one liter of sprinkle. Zalishte on nich, and vrantsi ztsidit. Take two thirds of three flasks per day.
2. Take 20 grams of elderberries, pour a bottle of sprinkle and pour it for a year. Let it sit and give honey for savor. Take one glass of three a day.
3. Take 5 grams (one teaspoon) of a young leaf of a hairy mountain and pour a bottle over the sprinkle. Let it brew and take it, yak tea.

What is the forecast?

The prognosis of non-bloody diabetes is mainly due to the fact that the form is diagnosed in a sick person. The main mass of ailments for non-bloody diabetics is a friendly prognosis for life, but not for money. A non-fertile diabetics does not add to the primacy and triviality of life, or, perhaps, to diminish the quality of life.

In case of severe diabetic diabetics, there are more patients with 3 disabilities. Iakshcho non-bloody diabetes is symptomatic - then, if the cause is weakened, it is infused. As soon as the bulo wicklikano becomes ill with trauma, then it is possible to update the functions of the hypophysis. As long as it is not a bad diabetic, then the irritation to the body will result in a stupor and a local Komi.

("Diabetes") - discomfort, which develops when there is a lack of vision of antidiuretic hormone (ADH) or a decrease in the sensitivity of a nirk tissue before the next day. As a result, you will see an increase in the number of years, as you see it from the cross, winniegamovnim like sprague. As soon as the life is lost, it is compensated in the general community, then the dehydration of the organism develops - anger, with rice what is the opposite of the polyuria. Diagnosis of non-congenital diabetes primed on classy paintings and the indicated level of ADH in the blood. For a reason for the development of a non-bloated diabet, a patient's general condition is to be carried out.

ICD-10

E23.2

Country houses

("Diabetes") - discomfort, which develops when there is a lack of vision of antidiuretic hormone (ADH) or a decrease in the sensitivity of nirk tissue before the next day. Disruption of the secretion of ADH by the hypothalamus (absolute deficiency) of any physiological role in case of sufficient education (mental deficiency); nirkovy tubulesі vivedennya її from a section of low wіth sociality. In case of unsuccessful diabetes, at the connection with the visions of a great volume, an unsecured thirst and gross degradation of the organism develop.

Non-fertile diabetic є In the 5th cutaneous type of non-congenital diabetes, it develops as an accelerated neurosurgical involvement.

Classification

accelerating

Non-fertile diabetics is not safe for the development of dehydration to the body, in quiet drops, if the loss of birth from the cross is not adequately remembered. Feverishness is manifested by a sharp backward weakness, tachycardia, blues, mental damage, thickened blood, hypotensive right up to collapse, neurological damage... To navigate in case of severe heat, polyuria can occur.

Diagnosis of non-congenital diabetes

Typical vapors allow the suspicion of non-congenital diabetes due to non-vascular pregnancy and vision more than 3 years per add. To assess the good quality of the cut, a test is carried out by Zimnitsky. At the end of the day, there is a low level of probability (<1005), гипонатрийурию (гипоосмолярность мочи - 100-200 мосм/кг). В крови выявляются гиперосмолярность (гипернатрийемия) плазмы (>290 mosm / kg), hypercalcemia and hypocalcium. Diabetes mellitus is susceptible to blood glucose levels. With the central form of non-bloody diabetes in the blood, there is a low vmist of ADH.

We will show the results of the test with dry eating: we will get rid of the length of time for 10-12 years. In case of non-vascular diabetes, the intake of vagi is more than 5%, while keeping a low natal vagina and hypoosmolarity of the section. The reasons for the unhealthy diabetes mellitus are due to radiological, neuropsychiatric, ophthalmologic dosages. About'єmnі insight into the brain is included in the MRI of the brain. For diagnostics of nircovaya form of non-uterine diabetes, ultrasound and CT nirok should be performed. Needed consultation of a nephrologist. Inodi for the differentiation of nirkovy pathology, biopsies of nirok are required.

Lіkuvannya uncrowned diabetes

Lіkuvannya of symptomatic non-bloody diabetes mellitus from a weakened cause (for example, pukhlini). For all forms of non-congenital diabetes, a synthetic analogue of ADH, desmopresin, should be used as a therapy. The drug is stagnant in the middle or intranasally (by way of filling in nis). Also mean prolongation of the drug from the oily range of pituitrin. In the case of the central form of non-circulating diabetes, chlorpropamide, carbamazepin are prescribed, which stimulate the secretion of antidiuretic hormone.

To carry out the correction of the water-salt balance by the way of infusion introduction of salt solutions at the great parties. Significantly change duresis in case of non-vascular diabetes sulfanilamide diuretics (hypochlorothiazid). Harchuvannya with unguarded diabetic will be on the interchange of a bottle (to change the option to nirki) and adequate intake of carbohydrates and fats, frequent consumption of fruits and vegetables. Drinking tamuvati sprague is recommended with juices, fruit drinks, compotes.

forecast

A non-bloody diabet that grows into period of operation for with vaginosti, often to wear a transitory (timing) character, idiopathic - navpaki, stiy. In case of an obvious likewise, they are not safe for life, they want to be smart about it.

Oduzhannya paciєntіv sposterіgaєt in the form of successful vidalennya poohlin, specific treatment of non-bloody diabetics, tuberculous, painful, syphilic diseases. With the correct recognition of hormonal therapy, it is not easy to get a preference. Nimensh cozily by stretching the nephrogenic form of non-bloody diabetes in children.

non-bloody diabet - getting sick, wicclican absolutely abo due to lack of hypothalamic hormone vasopresin (ADH-antidiuretic hormone).

The incidence of nevidoma is observed in 0.5-0.7% of endocrine ailments.

Regulation of vasopressin administration and efficacy

vasopresinі oxytocin is synthesized in the supraoptic і paraventicular nuclei of the hypothalamus, packed into granules with the form of neurophysiasis, and transported along the axon to the posterior part of the hypophysis (neurohypophysis), deserving to the extent that it is affected. The reserves of vasopressin in neurohypophysis in case of chronic stimulation of this secretion, for example, in case of a trivial loss of pressure, rapidly speed up.

The secretion of vasopressin is a lot of factors. We are important for them є osmotic grip of blood, Tobto the osmolality (aka the osmolality) of the plasmas. In the anterior hypothalamus near, ale near the supraoptic and paraventicular nuclei, osmoreceptori ... If the osmolality of the plasmas is at the normal minimum, or the threshold value, the concentration of vasopresin in it is even small. Even the osmolality of the plasmas is changing the setting threshold, the osmocenter of the cerebrospinal fluid, and the concentration of vasopressin is steeply moving. The osmoregulation system reacts even more sensitively and even more precisely. deyake zbіlshennya the sensitivity of osmoreceptori is tied to vikom.

Osmoreceptors are not the same sensitive to different words of plasmi. sodium(Na +) and yogo anioni are the most potent stimulants of osmoreceptor and secretion of vasopressin. In normal conditions, the osmolality of plasmas is 95%.

Deliver efficiently stimulate the secretion of vasopresin through the osmoreceptor sucrose і mannitol... Glucose practically does not stimulate osmoreceptor, so it is itself and sechovina.

The most important factor in the stimulation of the secretion of vasopressinNa + and osmolality of plasmas.

Pour vasopressin into the secretion blood circulation and arterial vise... The process of flowing in through the baroreceptors, rosetting in the atriums and duzi of the aorta. Stimulate from baroreceptors along afferent fibers to enter the stovbur brain in the storehouse of the blistering and lactopharyngeal nerves. Signals from the stovbur to the brain are transmitted to the neurohypophysis. A decrease in AT, or a decrease in blood loss (for example, blood loss), is significant to stimulate the secretion of vasopresin. Ale tsya system is significantly less sensitive, less osmotic stimulation on the osmoreceptor.

One of the two officials to stimulate wikid vasopressin, є nudota, Spontaneous, or wiklicana procedures (bluetone posit, alcohol, nikotin, apomorphin). Navigate when you come tedious, without blotting, vasopressin in plasma grows 100-1000 times!

Less effective, less tediousness, more than a constant stimulus to the secretion of vasopressin є hypoglycemia, especially gostra. Decreasing the glucose level by 50% of the total in the blood, it pushes against vasopressin by 2-4 times in humans, and in schurivs by 10 times!

Increasing the secretion of vasopressin renin-angiotensin system... The level of renin and / or angiotensin, which is necessary for the stimulation of vasopressin, is not yet known.

Get in the same way nonspecific stress, How can you be victorious with such factors as bil, emotsii, physical design, Pidsilyu secretion of vasopressin. However, it’s unavoidable, because the stress stimulates the secretion of vasopressin - like a special way, or through a decrease in the arterial grip and nudotu.

Galute the secretion of vasopressin vasoactivity of speech, such as norepinephrine, haloperidol, glucocorticoids, opioids, morphine. But it’s unclear why all the speech is central, because for the rakhunok there is a vice and the volume of blood.

Drinking vasopressin to the bloodstream quickly grows along the pozaklitinnoy age. Rivnovaga between the inner and outer space can be reached with a stretch of 10-15 minutes. Inactivation of vasopressin is obtained, in the main, in ovens. A small part does not collapse and see through the section in an intact viewer.

Efekti. An important biological defect for Vasopressin є saving the drive to the body by the way of lowering the vision of the battle. The point of the yogo dії є epitheliy of the distal and / or the small canaliculi nirok. For the vasopressin membrane vasopressin, the cytin, which whistles a part of the nephron, forms an indefinable interceptor for diffusion of water and phytoplasm. In such minds, hypotonic filtrate, which settles into more proximal nephron sections, passes without change through the distal tubule and small tubules. The pitoma of the vaga (genericity) is so low.

Vasopressin increased penetration of distal and green tubules for water. Oskіlki water is reabsorbed without osmotic rivulets, the concentration of osmotic rivulets in new ones grows, and її obsyag, so that more, changes.

Є Dani, scho muscle tissue hormone, prostaglandin E, drives vasopressin in nirkah. At its own expense, non-steroidal anti-pyretic agents (for example, endometacin), synthesis of prostaglandins in nirkas, increase the amount of vasopresin.

Vasopressin is also used for the development of postural systems, for example, on the blood vessels, the intestinal tract, the central nervous system.

thorn serve as irreplaceable additions to the antidiuretic activity of vasopressin ... Zhaga - tse learn how to consume water. Zhaga is stimulated by the factors that cause the secretion of vasopressin. Most effective among them є hypertonic middle. The absolute level of osmolality of plasmas, when sprague is seen, becomes 295 mosmol / kg. When blood osmolality is normal, it is seen with the maximum concentration. Jaga є a kind of galma, the main function of which polarity is to prevent the degree of dehydration, as it replaces the compensatory flexibility of the antidiuretic system.

Feel the spragy to quickly accept in direct fallowness of osmolality of plasmas and becomes unbearable, if the osmolality of all at 10-15 mosmol / kg is changing the threshold ryven. I will appreciate the sprague proportionally. Zmenshennya obsyagu blood or HELL also wiklicaє sprague.

Ethiology

The development of the central forms of non-uterine diabetes is based on the reduction of the development of the hypothalamus, or the posterior lobe of the hypophysis, that is, the neurohypophysis. The reasons are as follows:

інфекції state of the art for chronic: influenza, meningoencephalitis, scarlet fever, whooping cough, typhus, sepsis, angina, tuberculosis, syphilis, rheumatism, brucellosis, malaria;

craniocerebral trauma : Vipadkova abo hirurgic; training with an electric strum; childbirth trauma before the hour of flattening;

mental trauma ;

vagіtnіst;

hypothermia ;

pukhlina of hypothalamus or hypophysis : metastatic, or primordial. Metastasis in hypochondria, often breast cancer and thyroid glands, Bronkhiv. Infiltration with puffy elements for lymph granulomatosis, lymphosarcoma, leukemia, generalized xanthomatosis (hand-Schüller-Krispa ailments). Primary swelling: adenoma, gloma, teratoma, craniopharyngoma (especially often), sarcoidosis;

endocrine discomfiture : Syndromes of Simmonds, Sheehn, Lawrence-Moon-Bidl, hypophyseal nanism, acromegaly, hyganism, adinosogenital dystrophy;

idiopathic: in 60-70% of the sick, the reason for the disease is to be left unchecked. Among the idiopathic forms, less representative is the low-growth diabetics, which are observed in the decile generation. The type of sedation is autosomal dominant and recessive;

autoimmune : Destruction of hypothalamic nuclei as a result of an autoimmune process. This form, yak allowance, is less of the middle of idiopathic non-bloody diabetes, when there are autoantitila to vasopressin-secreting cells.

with peripheral For non-vascular diabetics, the production of vasopressin is saved, a little lower, because the sensitivity of the receptors of the nirkoval tubules to the hormone is reduced, or the hormone is able to fatigue in the liver, nirkas, placentas.

Nephrogenic non-congenital diabetes often spontaneously in children, and the understanding of the anatomical inconsistency of the nirkoval tubules (congenital calitus, cystic-degenerative processes), or the degenerative processes of the nephron (amyloidosis, sarcoidosis, for a decrease in the sensitivity of receptors in the epithelium of the nirkovy tubules to vasopresin.

Clinic for non-bloody diabetes

skargi

on sprague from the world to the big, but not letting go of the sick during the day, not at night. If you get sick, you will receive 20-40 liters of water for the addition. When tsomu vinikaє bazhannya take water for krizhan;

polyuriaі hastened the sequential release. See the light cut, without urochrome;

physical and mentalweakness;

lower appetite,thinning; great development obesity It is also a case of non-congenital diabetes that develops as one of the symptoms of primary hypothalamic disorders.

dyspeptic roses from the side of the shlunk - a feeling of discomfort, cutting, pain in the episode; intestines - constipate; zhovchnyi mikhura - heaviness, b_l at the right side;

mental and emotional damage: Headache, emotional neurological importance, sleeplessness, decreased pinkness, gratitude, tearfulness; In some cases, psychosis develops.

loss of menstruation, in people - potential.

anamnesis

An ear of zhvoryuvannya can be welcomed, rapt; more - we will act, and symptoms grow in the world of dying. In addition, it can be caused by traumas of the craniocerebral or mental, infectious, operative involvement on the brain. Most often, the reason for finding out is not to go in. Inodі vstanovlyuєatsya taut decrease in unguarded diabetes.

Techia chronic illness.

look around

emotional lability;

shkіrnі pokrivi dry, changed saliva and sweat;

the mass of tila may be reduced, normal or shifted;

mova is not very dry in sprague, between the slunk is lowered into a link with a permanently re-entangled ridino. With the development of gastritis or dyskinesia of young men, sensitivity and soreness can be increased when palpating an epigastric and right papilla;

heart-sudinna i dichny system, Pechinka zazvychay not suffer;

Secovision system: it is meant to accelerate the Secovipuskannya, polyuria, nikturia;

signsfeverishness an organism, as a matter of fact, is to get involved in the cross, for some reason not to remember - the visibility of the water, the test with the "dry food", otherwise the sensitivity to the center of the "spragi" is reduced:

cracking weakness, headache, tediousness, blues of bagatorazov, due to dehydration;

hyperthermia, sudomi, psychomotor zbudzhennya;

distribution of CCC: tachycardia, hypotonia up to collapse and Komi;

thickened blood: increasing the amount of Hb, erythrocytes, Na + (N136-145 mmol / l, or meq / l) creatine (N60-132 μmol / l, or 0.7-1.5 mg%);

pitoma, the thickness of the cut is low - 1000-1010, the polyuria is growing.

The phenomenon of hyperosmolar dehydration is especially characteristic of congenital nephrogenic non-bloody diabetes in children.

diagnose on the display of the classic signs of a non-bloody diabetes and laboratory and instrumental dosages:

polydipsia, polyuria

low pitoma section - 1000-1005

plasma hyperosmolarity,> 290 mosm / kg (N280-296 mosm / kg water, or mmol / kg water);

hypo-osmolarity of the section,< 100-200 мосм/кг;

hypernatremia,> 155 meq / l (N136-145 meq / l, mmol / l).

If necessary, carry out probi :

Dry food test. The test is carried out in the minds of the stationary, the triviality of it becomes 6-8 years old, with good tolerance - 14 years. Ridina is not given. She is guilty of butti Bilkovo. I try to pick up skin years, reduce the amount of skin and age. Vimіryuyut masu tіla pіslya 1 liter of vіtіlenoї slaughter.

assessment: The visibility of the sutta dynamics of natal slaughter in two advances at the expense of 2% mass indicates the visibility of the stimulation of endogenous vasopresin.

Sample in / in injections 50 ml 2.5% retailNaCl with a stretch of 45 min. With an inappropriate diabetics, the strength of the section does not change. With psychogenic polydipsia, the osmotic concentration of plasmas rapidly stimulates the wikid endogenous vasopressin and the number of vasopresin seen changes, and the number of pitomas increases.

A sample of the injected drugs in vasopresin - 5 OD intravenously or intramuscularly. With a true uncouth diabetes of self-esteem, polydipsia and polyuria decrease, the osmolarity of plasmas decreases, the osmolarity of the section moves.

Differential diagnosis of non-bloody diabetes

For the main signs of an unhealthy diabetes - polydipsia and polyuria and deficiencies, differentiation with a number of ailments, but against these symptoms: psychogenic polydipsia, congestive diabetes, lack of compensatory chronic polyuria in cases of malignancy.

Nephrogenic vasopressinresistant non-congenital diabetes (congenital abodes) differentiate for familiar polyuria with primary aldosteronism, hyperparathyroidism with nephrocalcinosis, malabsorption syndrome in chronic enteric.

With a bloody diabetes

Table 22

Psychogenic polydipsia

Table 23

Central (hypothalamohypophyseal) with nephrogenic non-uterine diabetes

Table 24

Lіkuvannya uncrowned diabetes

ethiological : With puffins of the hypothalamus or hypophysis - surgical involvement, Abo exchange therapy, cryodestruction, introduction of radioactive therapy.

In case of infectious processes - antibacterial therapy.

In hemoblastosis - cytostatic therapy.

replacement therapy - drugs that replace vasopresin:

Adiuretin(Synthetic analogue of vasopressin) Intranasal 1-4 drops in the skin nizdry 2-3 times a day; dispensed in vials of 5 ml, in 1 ml - 0.1 mg of active speech;

Adіurekrin(Extract of the back lobe of the hypophysis of the great horny thinness). Let the powder go to the eyes. Breathe in 0.03-0.05 2-3 times a day. The triviality of one inhalation is 6-8 years. In case of ignition processes in the emptying of the nose, the wetness of the adiurekrina and the efficiency of the nose will deteriorate;

RP: adiurecrini 0.05Dsd # 30.S. inhale by nose, 1 ml ampoules;

Pituytrin. Form to the release of 5 OD activity. Hydrochloric extract of the back lobe of the hypophysis of the great horny thinness. Introduce 5 OD (1 ml) 2-3 times per dose intramuscularly.Often wiklikє symptoms water toxicity(Headaches, abdominal pains, sneezing, headache) and allergies;

DDAVP(1 desamino-8D-arginin-vasopresin) - synthetic analogue of vasopresin;

sechogіnnі thіazіde group(Hypothiazide i in.). Hypothiazide, 100 mg per day, decreases glomerular filtration, excretion of Na + from changes in the number of sections. The effect of thiazide sechogins does not appear in all ailments for a non-bloody diabetic and in an hour of weakness;

chlorpropamide(Oral contraceptive drug) is effective in people with ailments with non-congenital diabetes. Tablets 0.1 і 0.25. designate in extra dose 0.25 in 2-3 priyomi. The mechanism of antidiuretic action is not responsible for the transmission, it is possible to transfer it to vasopresin, if there is minimal amount of it in the body.

In order to unify the hypoglycemia and hyponatrium, it is necessary to control the level of glucose and Na + in the blood.

Diabetes is called a country, when there is an increase in the number of visions by the body of a child and a compensatory spraga. Often these symptoms of diabetes mellitus are associated with glucose levels in the blood. However, in the medical diagnosis of "non-congenital diabetes", when the infusion of blood is not associated with the concentration of glucose.

Reasons for diagnosis and mechanism of development of pathology

Aggressiveness is chronic and often diagnosed in patients of 18-25 years of age. At the same time, there are drops, if the diagnosis is made of deliveries for thirty years, as well as for children of the first fate of life.

One of the symptoms of unhealthy diabetes in women - Sprague

There are two main mechanisms for the development of pathology - central and nephrogenic. The offense is tied to the vision of the hormone vasopressin and is sensitive to the new.

Clitini of the hypothalamus regulate the viroblation of vasopresin, an antiduretic hormone. Vasopressin spraying saves birth in the body and reabsorption of nirok, which can be reduced to a decrease in the number of slaughter. If there is a lack of vasopressin, the amount of moisture in the body changes, and through the polyuria it becomes more and more frequent.

The main problem is the lack of vasopressin, as there can be two reasons:

1. Neurohormonal diseases, which lead to a lack of hormone approval through damage to the central nervous system.
2. A decrease in the sensitivity of nyrc receptors to vasopresin, which often occurs through genetic damage.

Diabetes is of central genesis, with a lack of vasopressin, it can be vicious:

1. Ushkozhennymi gipofiza or hypothalamus, which produce to the destruction of the transport of the hormone or any lack of accumulation.
2. Injuries, ignited or infiltrative illnesses.
3. It is also diagnosed with idiopathic diabetes, for which the problem is overwhelmed by a genetic defect or incorrect immunological reactions.

Nircovy type of diabetes can also develop through a genetic defect, as well as due to additional pathological conditions - hypercalcifications, hypocalcifications, and injuries.

In such a rank, it is possible to see the first and second non-cerebral diabetics, as if they were present at the time of the people, or having appeared with an extension of life as the inheritance of illnesses and injuries.

Okremo vid_lyayut also non-bloody diabetics - a time-based pathology, as it is known to be on the floor. The reason for the whole drop is in the formation of vasopressin with placental hormones, which leads to a lack of antidiuretic hormone. The variability of symptoms is more likely to develop in the third trimester.

Lіkuvannya guilty passes under the control of a lіkar

Classification and classic painting

Non-fertile diabetics go on a number of types after the level of compensation and gravity:

• easy - a bit of slash, so you don't see it, 8 liters;
• middle - the patient spends up to 14 liters for dobu;
• important - without drug therapy to see more than 14 years old.

1. Compensation stage - sprague and part of going to the toilet is especially not turbulent.
2. Subcompensation - the patient is innocent to sprout and to pay for polyuria.
3. Decompensation - Sprague rolls and polyuria.

The symptomatology for diabetes is standard. Wine includes:

• skargi for strong sprague;
• a lot of water to drink by the patient up to 20 liters;
• decrease in potovіlennya;
• quickening і ryasne sechovipuskannya, go to the toilet at night;
• traces of great birth: dryness of the skin and slimy, weakness, headache, blues, sudom, thickened blood;
• expansion of the shlunk, reduction of the secretory function of the organs of the shlunkovo-intestinal tract.

Diabetes of the central genesis of the transmission of additional manifestations, tying to the damage of the robot, the hypothalamic-hypophyseal system (endocrine damage from the side of the other systems of organs).

Diagnostics and treatment

The head of the diagnostics is to find out the localization of the cause of the problem. As a matter of fact, there is a further tactic of therapy. In the diagnosis of viciousness, there is an advance of the following:

1. Test for intercourse rіdini. It is carried out in the clinic for the diagnosis of differential diagnosis of diabetics. The patient will take it dry and feel good for the skin 30 gilin. Doslidzhuєtsya rivn vasopressin and osmolarity of the sech.
2. Biochemistry and classroom analysis - an analysis showing a decrease in power below 1.005.
3. Diagnostics of the central type of non-congenital diabetes is carried out after additional MRI.

Tactics of therapy to find the cause of the diagnosis of unhealthy diabetes

Surgery for non-bloody diabetes is not carried out. Since psychogenic problems are the cause of the damage, the patient needs the consultation of a psychotherapist. In іnshikh vypadki the drug should be carried out with medication.

The main scheme of therapy for diabetes of central genesis є is replaced by therapy with an analogue of vasopresin - desmopresin. The dose is taken individually for the skin patient by a practical way. The bioavailability of new drugs based on desmopressin can be recognized, so it is necessary to respectfully know about the instructions and readily read them before the ear of treatment. CLINIC RECOMMENDATIONS lykarya.

Before the hour of therapy, the nutritional regimen is guilty - when spraga appears, it is obovyazkovo.

Ridin is especially not to be surrounded, so as it is prisvede to vnevodnenya, however, sending a cob of spraga torture the patient rіdshe.

Therapy of nephrogenic etiology for diabetes mellitus cannot be carried out with a different therapy, since the sensitivity of the receptors is too low. In general, there will be solutions to the use of anti-pyretic drugs, for example, thiazide diuretics.

The assessment of the quality of the test is carried out 1 time at a time or more often. At the same time assess:

• sprague frequency;
• the results of the analysis of the section;
• durez;
• concentration of glucose, sodium, calories, creatine in blood;
• frequency of n_chnyh sechovipuskan.

No prophylactic visits for the prevention of non-bloody diabetics have been made. Pathology to appear unsupported and in a serious approach to treatment.

In case of unsuccessful diabetics, as a result of injuries or surgery, the patient has a good chance of remission.

The remission is often infused after 3-6 months after the start, and it is possible to allow for a decrease in the dose, for example, in addition to the hormonal intake.

The treatment of non-bloody diabetes in vaginal women can also be carried out with desmopresin. Therapy for non-bloody diabetes folk zasob not very effective.

Forecast and nebezpeka zhvoryuvannya

Non-fertile diabetics and symptoms in women and men can lead to destruction of the robotic systems of organs, and also can significantly reduce the quality of life. At the time of the central genesis of non-bloody diabetes, there is a significant etiology of the problem. The health of the hypothalamus in pukhlinoyu makes an unpleasant prognosis through malignant approval, and not through diabetes.

Anyone who has a problem is not safe to lose a lot of money. Electricity consumption and consumption can lead to a lethal result, especially in young children and toddlers.

When the riziki is lowered, as the patient will remember to spend the way, he will be obliged to pay off the life of the water.

Carrying out a different therapy allows for a significant improvement in the quality of life of patients and minimization of problems in cases of ill health. at correct loveі regular monitoring of the sick prognosis of non-bloody diabetics.

If there is adequate therapy for non-congenital diabetes, it can be brought to:

• poorushen from the side of the zoru;
• neuroses, problems with sleep, sickness in robots nervous system, As soon as possible to improve the development of pathology;
• adjustments to the growth and development of children;
• expansion of nirk bowls, expansion of chafing mikhura;
• overstretching of the slunk;
• discines of young people;
• teasing of the intestines, constipation;
• dermatological problems;
• problems with the heart and the vessels through the lack of birth in the body.

Nezavisimye inheritance can also be blamed as a result of hypernatremia, if the element is lost in the blood, and some of the water changes, causing the concentration of sodium. By the manifestation of this, I will begin to p_dvishchena nerve-m'yazov zvudliv_st, ruined svidomost_, sudom.

Non-blood diabet maє chronic overrun and obstruct the organisms. With the correct likeness of the life of the patient, it will be seen. Pathology of a disease through genetic damage or a pathology of accelerated injury and illness.