When discussing Diabetes Insipidus and Diabetes Mellitus it is critical to understand the differences with these two disorders.

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When discussing Diabetes Insipidus and Diabetes Mellitus it is critical to understand the differences with these two disorders. Diabetes Mellitus is a group of diseases classified by high blood sugars (hyperglycemia) due to a defect of insulin secretion or actions (Huether & McCance, 2014). While Diabetes Insipidus is an insufficiency of the Antidiuretic hormone (ADH) (Huether & McCance, 2014). ADH is a hormone that helps your kidneys manage the amount of water in your body (Huether & McCance, 2014).

   While diabetes mellitus (DM) is a common disease that affects 30 million Americans (American Diabetes Association, 2018).  Diabetes Insipidus (DI) is a more rare disorder (Huether & McCance, 2014).  Both DM and DI have a component related to genetics, patients with DM are predisposed and something in the environment triggered insulin in the body to react (American Diabetes Association, 2018).  DM includes type 1 (juvenile diabetes) or type 2, and as well as gestational diabetes during pregnancy (Huether & McCance, 2014). DM requires management of the disease, including self-management, dietary changes, frequent follow-ups, and pharmacological treatments (Arcangelo, Peterson, Wilbur, & Reinhold, 2017).

While symptoms of both DM and DI include excessive thirst, and excessing urination, determining the correct disease is vital (Arcangelo et al., 2017). Patients with DM will have elevated A1C, and a fasting plasma glucose (FPG), (American Diabetes Association, 2018). While patients with DI will have diluted urine, sodium levels can elevated, the provider will order a ADH level, as well as a water depravation test to determine if high volume of diluted urine output despite stopping fluids for a couple of hours (NIDDK, 2015).

Treatment of DM needs to be tailored to each patient (Arcangelo et al., 2017).  First line therapy for type DM includes four injection of different types of insulin (Arcangelo et al., 2017). Long-Acting insulin once daily usually glargine (Lantus) this can be given based on weight (Arcangelo et al., 2017). Patients will also require short-acting insulin at meal times (Arcangelo et al., 2017). Regular insulin is short acting and can be given before meals depending on blood sugar reading, two units for blood sugar 120-140, four units 140-180 and six units for 180 and above (Arcangelo et al., 2017).

Treatment for DI includes a man-made hormone called desmopressin (DDAVP, Minirin) (Huether & McCance, 2014). Desmopressin replaces the missing anti-diuretic hormone (ADH) and decreases urination, it can be taken as a nasal spray, oral tablets or by injection (Huether & McCance, 2014).

American Diabetes Association, (2017). Diabetes Basics. Retrieved from: 

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017).  Pharmacotherapeutics for advanced practice: A practical approach  (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Huether, S. E., & McCance, K. L. (2014). Pathophysiology the biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby

National Institute of Diabetes and Digestive Kidney Disease [NIDDK]. (2017). Managing diabetes. Retrieved from: 

National Institute of Diabetes and Digestive Kidney Disease [NIDDK]. (2015). Diabetes Insipidus. Retrieved from: https://www.niddk.nih.gov/health-information/kidney-disease/diabetes-insipidus