Abstract
#Diabetesinsipidus is mainly characterized by polyuria, urinary
volume over 3 L/day or 40mL/kg/day in adults, leading to subsequent
#polydipsia; these features are also present in most cases of diabetes
mellitus. We report the case of a 56-year-old man initially misdiagnosed
with and treated for #diabetesmellitus; he was eventually diagnosed with
central diabetes insipidus following further laboratory tests. We have
also conducted a thorough review of the literature relating to the
physiology, #diagnosis, and treatment of diabetes insipidus. The patient,
who
complained of polyuria, polydipsia and weight loss, and had fasting
glucose levels of 108 mg/dL, was already using metformin to treat type 2
diabetes. He then developed hypoglycemic symptoms, and pre- and
postprandial capillary #glycaemia between 70 and 120 mg/dL, as a result
of
which metformin was suspended. Nevertheless, polyuria and polydipsia
persisted. Based on a #plasmaosmolality of 305,5 mOsm/kg, urinary
density of 1005 g/mL and low arginine vasopressin levels, a diagnosis of
central diabetes insipidus was made and treatment with was initiated. Because the symptoms of central diabetes insipidus and
uncontrolled type 2 diabetes mellitus overlap, it is important to
consider
clinical presentations carefully in order to make a differential
diagnosis.
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