Shin Hyun-Jong, Kim Jae-Ha, Yi Joo-Hark, Han Sang-Woong, Kim Ho-Jung
Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
Electrolyte Blood Press. 2012 Dec;10(1):26-30. doi: 10.5049/EBP.2012.10.1.26. Epub 2012 Dec 31.
We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 µg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.
我们报告了一例罕见的中枢性尿崩症(CDI)与2型糖尿病(DM)并发的病例。一名56岁男性患者于两个月前在当地诊所因多尿、烦渴伴高血糖被诊断为2型糖尿病,并开始口服降糖药物治疗,但症状完全没有改善。入住大学医院时,患者初始空腹血糖水平为140mg/dL,每日尿量超过8L,存在烦渴和多尿症状。尽管使用二甲双胍和饮食控制了高血糖,但他的症状仍然持续。包括禁水试验在内的进一步检查证实了存在不明原因的并存CDI,使用去氨加压素鼻喷雾剂(每日10μg)后,患者包括强烈口渴在内的症状明显改善。通过回顾文献中少数相关成人病例,提出了CDI和2型糖尿病存在共同病因的可能性。