Dr. Nguyen Thi Kim Tuyen, from the Department of Endocrinology and Diabetes at Tam Anh General Hospital Ho Chi Minh City, states that diabetes insipidus affects about one in 25,000 people and is distinct from diabetes mellitus.

Both diabetes insipidus and diabetes mellitus can cause frequent urination and intense thirst, leading to easy confusion. However, diabetes mellitus is a metabolic disorder that results in elevated blood sugar. In contrast, diabetes insipidus is unrelated to blood sugar levels; it stems from the body's deficiency in antidiuretic hormone (ADH) or the kidneys' reduced response to this hormone, impairing water retention. Patients with diabetes mellitus typically have concentrated, dark urine, while those with diabetes insipidus produce very dilute, pale urine.

Hieu was admitted to Tam Anh General Hospital Ho Chi Minh City with elevated blood sodium levels of 150 mmol/L (normal is about 135 mmol/L). He presented with low blood pressure and dehydration, which led to an electrolyte imbalance. Doctors initiated aggressive fluid replacement and monitored his fluid balance (tracking the equilibrium between fluid intake and output over 24 hours) to address dehydration and stabilize blood pressure.

Laboratory test results showed his blood sugar was normal, but both urine specific gravity and urine osmolality were decreased. An MRI scan revealed a hypothalamic-pituitary lesion. Dr. Tuyen diagnosed Hieu with central diabetes insipidus, attributing it to hypothalamic-pituitary damage following craniopharyngioma surgery one year prior.

After two weeks of medication, lifestyle adjustments, and attention to daily nutrition, the patient's thirst and urination frequency decreased. He continues to maintain his treatment regimen and attend scheduled follow-ups.

Dr. Tuyen re-examines Hieu. Photo: Tam Anh General Hospital

Dr. Tuyen re-examines Hieu. Photo: Tam Anh General Hospital

According to Dr. Tuyen, distinguishing between diabetes insipidus and diabetes mellitus is crucial because their diagnostic approaches and treatment protocols are entirely different. Diabetes mellitus treatment focuses on blood sugar control through a combination of diet, physical activity, and medication. The goal of diabetes insipidus treatment is to manage the body's water balance using medication or synthetic hormones.

If patients with diabetes insipidus do not adequately replace the water lost through urine, the body can suffer severe dehydration, electrolyte imbalance, and sodium deficiency, leading to symptoms such as fatigue, dizziness, low blood pressure, and confusion. Dehydration and electrolyte imbalance can directly impact the cardiovascular system, increasing the risk of arrhythmias and stroke.

Individuals experiencing persistent thirst and frequent urination should consult a doctor for an accurate diagnosis and appropriate treatment.

Bach Duong

*Patient's name has been changed