Polydipsia

Introduction

Introduction

More drinking is caused by diabetes. Diabetes is caused by genetic factors, immune dysfunction, microbial infections and their toxins, free radical toxins, mental factors and other pathogenic factors that cause islet dysfunction and insulin resistance. Insulin Resistance, IR), etc. A series of metabolic disorders such as sugar, protein, fat, water and electrolytes are clinically characterized by hyperglycemia. Typical cases may include polyuria, polydipsia, polyphagia, weight loss, etc. Performance, that is, "three more than one less" symptoms.

Pathogen

Cause

People with diabetes can't convert the sugars absorbed by the human body from food into liver glycogen and muscle glycogen at the normal level. The sugar they absorb can not be reused after being decomposed into glucose in the way of the human sugar cycle. The kidneys used to filter impurities in the blood absorb the glucose from the blood into the urine, then transfer it to the bladder, and then discharge it. The osmotic pressure of the urine is high, and the water is discharged more. Of course, when the body needs less water, it is thirsty, so drink more.

Examine

an examination

Related inspection

Glucose glycated hemoglobin blood routine

Blood sugar (GLU)

Normal reference value: 3.6-6.1mmol/L

Clinical significance:

1 Physiological hyperglycemia: common in 1-2 hours after a meal, intake of high-sugar foods or increased emotional adrenaline secretion.

2 pathological hyperglycemia: endocrine gland dysfunction causes hyperglycemia, increased intracranial pressure, hyperglycemia due to dehydration, anesthesia, infectious diseases, hyperglycemia can occur under the condition of toxemia.

3 physiological hypoglycemia: can be seen in hunger and strenuous exercise.

4 pathological hypoglycemia: anti-insulin hormone secretion, severe liver disease patients.

Note: After taking the blood, centrifuge the serum as soon as possible and test it.

2. Oral Glucose Tolerance Test (OGTT)

Normal reference value: fasting blood glucose: 3.89-6.1mmol/L.

One hour after meal, blood glucose: <10 mmol/L.

Two hours after meal, blood glucose: <7.8 mmol/L.

Three hours after the meal, blood glucose: 3.89-7.8 mmol/L.

Clinical significance:

1 normal curve: no matter whether the fasting blood glucose is higher or lower than 6.1mmol/L, the peak value is 0.5-1 hour after oral glucose, and the peak value does not exceed 10mmol/L for 2 hours and returns to the fasting level.

2 Diabetic curve: fasting blood glucose is higher than normal people, the peak value is >10mmol/L, the decline is slow and the peak is shifted back, and urine sugar appears. The important indicator is that the blood glucose is still higher than 7.8mmol/L after two hours of oral glucose. Fasting blood glucose is normal and OGTT 2 hour blood glucose > 11.1 mmol / L can be diagnosed as diabetes. If the fasting blood glucose is >7.8 mmol/L, and the OGTT blood glucose level is 8.0-10.9 mmol/L, diabetes can also be diagnosed.

Note: Three days before the test, the daily intake of carbohydrates should not be less than 150g, maintain normal activities, stop all kinds of drugs that affect glucose metabolism, and fast at least 10 hours before the test. Tea, smoking or eating is prohibited during the test.

3. Glycated hemoglobin A1c (HBA1c)

Normal reference value: 3.8 - 6.5%.

Clinical significance: Glycosylated hemoglobin reference unit (%) refers to the percentage of total hemoglobin. GHb is the sum of HBA1a, b, and c, and HBA1c is about 70% structurally stable. Therefore, HBA1c can be used as a monitoring indicator for diabetes control. The concentration of glycated hemoglobin reflects the average blood glucose level 1 to 2 months before the measurement. In particular, type I diabetes is measured 1-2 times a month to better understand the extent of disease control.

Diagnosis

Differential diagnosis

For the typical symptoms of diabetes, unlike some spiritual polydipsia, it is clinically combined with other signs to make judgments. Symptoms of polydipsia should be distinguished from the following symptoms:

Polydipsia and polydipsia: Diabetes insipidus often accompanied by polydipsia and polydipsia, or fever, dehydration, or even convulsions. Diabetes insipidus is caused by the lack of antidiuretic hormone (ie, arginine vasopressin, AVP for short) and the dysfunction of renal tubular reabsorption of water, which causes polyuria, polydipsia, polydipsia and low specific gravity urine. a disease. The disease is caused by lesions in the hypothalamic-neuronal pituitary, but some cases have no obvious cause. Diabetes insipidus can occur at any age, but it is more common in young people.