PRESENTED TO:

MAM RATTAN KAUR PRESENTED BY :

ANIQ UR REHMAN REG NO:

2015-MPHIL-2145

Human Nutrition Disorders & Disease Prevention(FNUT-01008)

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Diabetes insipidus (DI) is a condition characterized by excessive thirst and excretion of large amounts of dilute urine

WHAT IS DIABETES INSPIDUS?

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To understand signs and symptoms

Difference between DI and DM

Prevalence of DI

Diagnosis

pathophysiology

Classification

Medical nutrition therapy

references

ROAD MAP

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DI 1.decreased production of ADH(central diabetes insipidus)2.Decresed kidney's response to antidiuretic hormone (nephrogenic diabetes insipidus)

DM Polyuria due to the high blood sugar level, it is due to absence of insulin which convert glucose to glycogen in muscles and liver..

DIFFRENCE BETWEEN DI AND DM

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• Excessive urination and extreme thirst

• urine does not contain glucose

• Signs of dehydration may also appear.

SIGNS AND SYPTOMS

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• In children, DI can increases appetite and weight gain.

• In adults it causes dehydration and loss of potassium in urine and causes hypokalemia

CONTIN…

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3 in 100,000 each year having DIStarts in childhood or early

adulthood Affects men more commonly than

women

PREVALANCE

To differentiate DI from other causes of excess

urination, blood glucose levels, bicarbonate levels,

and calcium levels need to be tested

Level of Na is high in blood (hypernatremia)

Specific gravity of urine is low

DIAGNOSIS

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Urine osmolality is low 1 a defect in ADH production 2 a defect in the kidneys' response to ADH

CONTIN…

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In DI Low ADH is produced due to damage to posterior pituitary glandADH increases the permeability of last part of nephron to reabsorb water. When there is low ADH ,water is not reabsorbed and

excreted as urine

PATHOPYSIOLOGY

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CLASSIFICATION OF DI

Neurogenic diabetes

insipidus

Nephrogenic diabetes insipidus

Dipsogenic DI or primary

polydipsia

Gestational diabetes inspidus

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also called central DI,due to decresed ADH.

CausesDamage to posterior lobe of pituitary gland.

It is inability of the kidney to respond normally to ADH

Neurogenic Nephrogenic

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excessive intake of fluids due to a defect in the thirst mechanism, located in the hypothalamus, or due to mental illness

occurs during pregnancy and the postpartum period.

Dipsogenic Gestational

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MEDICAL NUTRITION THERAPY

1. Avoid Salty Foods At All CostsSalt enhances the thirst.Any foods with high sodium should be off-limits

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To reduce the amount of urine production.

THE GOAL

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Caffeine in excessive amounts causes the kidneys to excrete excessive urine. It is found in: Beef jerky Chewing gum Aspirin and other OTC medications Chocolate

2. Stop Using Caffeinated Products Whenever Possible

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Processed food has preservatives in which sodium is present .And Na causes increased thirst.

3. Processed Foods Must Be Avoided At All Costs

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Proteins breakdown to form urea and urea also cause increased excretion of urine.

Fish, eggs, and even poultry should all be avoided in excess ,Even legumes and nuts .

Recommended levels of protein is still required .

4. Reduce The Amount Of Protein That Is Being Consumed

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Foods that are rich in water may be recommended as a way to avoid drinking more fluids

Melons, fruits, and certain vegetables all have high water content in them with the vitamins and minerals the body needs

5. Water-Based Foods May Be Beneficial

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Beets has high amount of Na 60mg of sodium in it Carrots are also remarkably salty. Just one large

carrot m up to 25mg of salt in itSpinach Just one cup of boiled spinach has 125mg

of salt to it

What Foods Should Be Avoided Most Often?

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Human milk is preferred in infancy because protein constitutes 6% of caloric intake

Sodium intake should be reduced to 0.7 mEq/kg per day. In a child who has nephrogenic diabetes insipidus, protein intake should constitute 8% of caloric intake

CONTIN…

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The tendency toward hypokalemia can be countered with potassium supplementation or the use of potassium-sparing diuretics, such as amiloride 0.1 to 0.2 mg/kg per day to a maximum of 10 mg/kg per day

CONTIN…

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In hereditary diabetes insipidus, genetic counseling and follow-up are important, Finally, the body temperature, appetite, and linear growth should be monitored

NOTE

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