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Medicina (Buenos Aires)
Print version ISSN 0025-7680On-line version ISSN 1669-9106
Abstract
PALUMBO, Claudia et al. Asociación de diabetes insípida central y diabetes mellitus tipo 2. Medicina (B. Aires) [online]. 2018, vol.78, n.2, pp.127-130. ISSN 0025-7680.
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; Type 2 diabetes mellitus; Elderly adult.