A young German is in the news because he has to drink 20 liters of water a day to survive. His story could be surprising but unfortunate if he did not suffer from a rare but well-known disease: diabetes insipidus. This form of diabetes is rare and a curiosity of medicine: patients are always thirsty, they drink a lot, a lot, and urinate as much! They do not have a social life any time. But, thankfully, it's easy to diagnose, and most of all, it's good.
By dint of using the word "diabetes", one forgets its origin. This name comes from the Greek "diabainen" which means "siphon". Because the main sign of recognition of this disease is that patients do too much peeing.
And we forget that aside from diabetes mellitus, which everyone knows, there is another type of diabetes called "tasteless". The blood tests that show that there is too much sugar in our body are quite recent. Formerly the only way to know if there was too much sugar evacuated by our body was to see it in the urine ... by tasting! Diabetes tasteless, that is to say very diluted urine and tasteless as opposed to diabetes mellitus where urine is sweet!
5 to 20 liters of urine a day
The patient is very thirsty and urinates a lot. In diabetes insipidus, we talk about 5 to 20 liters of urine per 24 hours! And, of course, with a permanent thirst, so an equivalent consumption of liters of liquid to drink each day.
It is in fact the consequence of a vicious circle due to the inability of the kidneys to concentrate the urine, for lack of a hormone, the antidiuretic hormone. A hormone secreted by a tiny gland in the base of the brain called the pituitary gland.
A fairly simple diagnosis
If you are thirsty all the time and spend your life in the bathroom, the diagnosis is not very complicated ... except that there are two diseases with the same symptoms but not the same order. In diabetes insipidus the patient drinks because he urinates too much. In the other illness, potomania, the patient urinates a lot because he drinks too much and not the other way around. Potomania is a psychiatric illness with "hyperdiuresis training".
To find out, the patient is hospitalized and deprived of drinks. In this case, even if he is not happy the potomaniac becomes a normal individual very quickly. On the other hand, if it is diabetes insipidus, the urine remains abundant, and the patient is dehydrated. If you suspect diabetes insipidus, you will have tests especially MRI, this extremely accurate radio that will show if this gland, the pituitary gland is in good condition.
Several reasons can explain that this small gland works badly: a family deficiency, but here we know very quickly. Head trauma, cyst, meningitis, or simple lithium therapy may also be responsible. And then we will be honest, in more than half of the cases, we find no cause.
It is treated ... And rather well!
It could not be simpler ... The patient is given an equivalent of the hormone that is lacking: antidiuretic hormone as a substitute. It is a treatment for life, except for example, in the case of a trauma where the gland will gradually return to normal function.
This is the small price to pay for a life and thirst ... perfectly normal.