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Introduction
Diabetes mellitus and diabetes insipidus represent different forms of alterations in a person’s processes of hormonal regulations. These disorders have many unique qualities that they do not share. The onset of diabetes insipidus is caused by the dysfunctional hypothalamic-pituitary system, while diabetes mellitus is connected to issues with the endocrine pancreas (Huether & McCance, 2017).
However, some of their symptoms, including increased thirst and polyuria can be highlighted as similar features of both conditions (Hammer & McPhee, 2014). Thus, the disorders may be difficult to distinguish without additional diagnostic measures. Such patient factors as ages and gender affect the development of both conditions. Diabetes insipidus and diabetes mellitus have different pathophysiological processes but possess some similarities in their clinical manifestations; the occurrence rates also differ by gender and age.
Pathophysiology
The pathophysiology of the discussed conditions differs depending on the cause. Diabetes mellitus has multiple types, each of which has a distinct set of processes. Type 1 diabetes mellitus is a chronic disorder that often manifests itself as an autoimmune response of the body to insulin. In the pancreas, the immune system activates T-cells that destroy beta cells, decreasing the production of insulin as a result (Huether & McCance, 2017).
In type 2 diabetes mellitus, some factors such as the abundance of insulin antagonists, altered glucose transporter proteins, or abnormal molecules of insulin lead to the increase in insulin resistance (Hammer & McPhee, 2014). Thus, while the body may produce insulin, the latter does not reach vital organs.
Diabetes insipidus can also develop in multiple ways, including central (neurogenic) and nephrogenic types. Central diabetes insipidus develops when the body does not produce a sufficient amount of anti-diuretic hormone (ADH) (Huether & McCance, 2017).
This can be caused by any type of brain lesion as wells as some genetic disorders. Neurogenic diabetes occurs in a hereditary pattern – the renal tubules of the affected person do not respond to ADH adequately, causing a disbalance in water regulation (Huether & McCance, 2017). As can be seen, the pathophysiology of the two disorders differs. However, water regulation problems can be seen in both conditions because, in diabetes mellitus, the high concentration of glucose causes reabsorption and dehydration.
Patient Factors
While genetics significantly influence the prevalence of the discussed disorders, other factors such as age and gender also play a crucial role in the conditions’ development. The frequency of occurrence of nephrogenic diabetes insipidus in men is much higher than that in women, while women develop diabetes mellitus (type 2) more often than men (American Diabetes Association, 2014; Bockenhauer & Bichet, 2015). Thus, the process of diagnosis should acknowledge this distinction in order to avoid an incorrect diagnosis. Women of childbearing age may be at risk for acquired conditions, especially if they are pregnant (American Diabetes Association, 2014).
Moreover, type 2 diabetes mellitus has a higher rate of occurrence in people older than 45 (Hammer & McPhee, 2014). On the other hand, diabetes insipidus occurs in people of all ages. In geriatric patients, it may be connected to lithium medications used to treat various mental health disorders (Bockenhauer & Bichet, 2015). Neonatal diabetes insipidus is also possible, it can lead to high rates of comorbidity (Djermane et al., 2016). Both groups should be treated with increased attention to the potentially exacerbating factors.
Conclusion
The differences between diabetes mellitus and diabetes insipidus are based on their pathophysiological processes. In the first disorder, the production and reception of insulin become the main issue. In the second type, the production of ADH affects the body’s water regulation system. Nonetheless, both conditions result in the person developing polydipsia and polyuria. The disorders affect people of all ages and genders, but risk groups exist for both conditions. Old age and female gender should be considered when diagnosing and treating diabetes mellitus, while male gender and old and young age are risk factors for some types of diabetes insipidus.
References
American Diabetes Association. (2014). Diagnosis and classification of diabetes mellitus. Diabetes Care, 37(Supplement 1), S81-S90.
Bockenhauer, D., & Bichet, D. G. (2015). Pathophysiology, diagnosis and management of nephrogenic diabetes insipidus. Nature Reviews Nephrology, 11(10), 576-588.
Djermane, A., Elmaleh, M., Simon, D., Poidvin, A., Carel, J. C., & Léger, J. (2016). Central diabetes insipidus in infancy with or without hypothalamic adipsic hypernatremia syndrome: Early identification and outcome. The Journal of Clinical Endocrinology & Metabolism, 101(2), 635-643.
Hammer, G. D., & McPhee, S. J. (2014). Pathophysiology of disease: An introduction to clinical medicine (7th ed.). New York, NY: McGraw-Hill Education.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
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