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Q.Distinguish between diabetes insipidus and diabetes mellitus.

Kerala DhseKerala DHSE Plus One Board 2022Subjective· 2mImportance★★★★★
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Despite the similar name, the two 'diabetes' are caused by different hormones — insipidus by a lack of ADH affecting water reabsorption, mellitus by a lack of effective insulin affecting blood glucose.

Both disorders are endocrine in origin but involve entirely different hormones and mechanisms:

Diabetes insipidus

  • Caused by deficient secretion of antidiuretic hormone (ADH/vasopressin) from the posterior pituitary (or by the kidney failing to respond to it).
  • ADH normally promotes water reabsorption in the distal convoluted tubule and collecting duct of the nephron; without it, very little water is reabsorbed.
  • Result: excretion of a large volume of dilute (watery) urine, with excessive thirst; blood glucose levels remain normal, and there is no glucose in the urine.

Diabetes mellitus

  • Caused by insufficient insulin secretion (or insulin resistance), insulin being secreted by the β-cells of the islets of Langerhans in the pancreas.
  • Insulin normally lowers blood glucose by promoting its uptake and utilisation/storage by cells; without adequate insulin action, blood glucose remains persistently high (hyperglycaemia). …

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