[Association between central diabetes insipidus and type 2 diabetes mellitus]

Medicina (B Aires). 2018;78(2):127-130.
[Article in Spanish]

Abstract

Central diabetes insipidus is a rare disease of the hypothalamus and neurohypophysis. It is very unusually found in the adult with type 2 diabetes mellitus. It is manifested by a polydipsic polyuric syndrome, which must be distinguished from the poorly controlled type 2 diabetes mellitus. Given the similarity of both entities and the unusual nature of their coexistence, their suspicion is difficult. The case of a 72-year-old male with type 2 diabetes mellitus with poor insulin control (fasting hyperglycemia greater than 180 mg/dl) who had a long-standing polyuric syndrome is here presented. Hypernatremia and plasma osmolality elevated together with a low urinary osmolality led to the suspicion of diabetes insipidus, which was subsequently confirmed by the dehydration test and the administration of desmopressin sc. With 61% increase in the calculated urinary osmolarity one hour post desmopressin s.c., diabetes insipidus of central type was diagnosed. Nuclear Magnetic Resonance showed a bright spot with normal neurohypophysis, contributing to the diagnosis of the idiopathic form.

Keywords: central diabetes insipidus; elderly adult; type 2 diabetes mellitus.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Diabetes Insipidus, Neurogenic / blood
  • Diabetes Insipidus, Neurogenic / complications*
  • Diabetes Insipidus, Neurogenic / diagnosis*
  • Diabetes Insipidus, Neurogenic / urine
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / urine
  • Diagnosis, Differential*
  • Gadolinium DTPA
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Osmolar Concentration
  • Pituitary Gland, Posterior

Substances

  • Gadolinium DTPA