14/05/2022 / Endocrinology & Diabetes
Diabetes mellitus is difficult to handle alone and when severe dehydration adds to it, it causes many complications and disorders like kidney disease
The scarcity of water in the body caused due to the unavailability of fluids is called dehydration. This will occur when you take less water/fluids or when your body loses all the fluid reserves.
Water is required for the proper functioning of the body to perform its daily activities. Our body comprises 75% water that helps in various functions of our body. You may face mild dehydration, moderate dehydration, or severe dehydration based on the severity of water loss from your body.
It is found that 77% of people do not drink enough water. Only 23% of people always remember to drink water and stay hydrated.
Water helps in -
Digestion
Excretion
Absorption of nutrients
Lubrication of joints
Production of saliva
Supply oxygen
Cushion for bones
Control body temperature
Shock absorber of the brain, spinal cord, and fetus
Water is lost from the body as sweat when your body temperature is raised by exercise, fever, and warm weather. Loss of water or fluids from the body will reduce the body water level and lead to dehydration.
Signs of mild to moderate dehydration can be identified with the following symptoms -
Headache
Dried mouth, lips, and eyes
Dizziness or tired
Dark yellow urine with a strong smell
Constipation
Mood swings
Hunger for sweets
Dried or flaky skin
Muscle cramps
Signs of severe dehydration can be identified with the following symptoms-
Pee little or no peeing
Excessive thirst
Weakness
Sunken eyes
Extremely dry
Lack of urination
Delirium or unconsciousness
Severe dizziness
Breathing difficulty
Lower blood pressure
High heart rate
Dehydration is caused due to
Excessive fluid loss
Decreased water intake
Increased sweating
Abdominal surgery
Vomiting or diarrhea
Haemorrhage or fistula
Diabetes
Increased use of laxatives
Fever
Treatment like hemodialysis or peritoneal dialysis
Renal failure with polyuria
Burns
Mild dehydration is caused by fluid loss or diminished fluid intake that leads to a decrease in total body water level.
Moderate dehydration occurs when your body fluid is decreased by 5-10% in infants and 3-6% in children.
Severe dehydration is due to extreme heat, illness, not enough water, and medications.
Complications of dehydration are due to severe dehydration or internal diseases like diabetes mellitus, kidney failure, and other kidney diseases like polycystic kidney disease.
Complications of dehydration include-
Brain inflammation
Coma
Seizures
Heart injury
There is a relation between dehydration and internal diseases. Severe dehydration will impact these disease conditions in different ways. Let’s understand the association of dehydration with diabetes mellitus, kidney failure, and other kidney diseases like polycystic kidney disease.
Any illness during diabetes mellitus can easily lead to dehydration. Dehydration during diabetes mellitus makes it harder to control blood sugar levels. Diabetes mellitus (hyperglycemia) is a condition where your body is unable to produce enough insulin to convert glucose into glycogen. Insulin is secreted by the pancreas that is controlled by the pituitary gland.
Due to improper functioning of the pituitary gland increased intake of sugar can lead to diabetes mellitus. Increased blood glucose levels will impact kidney function. Your body tries to decrease blood glucose levels by eliminating it through urine.
With increased blood sugar levels, your kidneys increase filtration more than usual to flush the excess sugar through urine. This will increase water elimination from your body leading to dehydration.
Excessive thirst is the primary sign of dehydration caused by diabetes. It is necessary for people who experience dehydration due to diabetes to increase water intake to lower the risk of fluctuation in blood glucose levels. You need to increase the number of glasses of water during high temperatures.
Loss of water or chronic dehydration is dangerous for people with diabetes and also for everyone. Water intake is important for each and every function of your body. The fluid levels in the body help you to stay active and healthy.
Follow these simple steps to stay hydrated during diabetes mellitus:
Replace sugary drinks like sweet beverages or soda with plain water or unsweetened tea
Keep a large reusable water bottle nearby to remind you to drink
Wherever you go carry a small portable water bottle with you
Add oral rehydration salts for diabetes with your eight glasses of water daily
Use apps that are free on the internet to remind you of drinking water
Try using a straw, it helps to hydrate your lips and drink more than usual
Always have two glasses of water before meals to make you feel full
Increase consumption of fruits and vegetables that contain water like watermelon, strawberries, cantaloupe, peaches, oranges, cauliflower, celery
Drink more glasses of water to provide enough fluids to promote hydration
Take cool water baths or ice baths to let down the body temperature
increase intake of fruit juices like orange or watermelon during summer
Drink coconut water in the hot climates to get instant energy
Take of fluids like lemon juice that are easily made in home to substitute electrolytes
Give buttermilk and oral rehydration salts for diabetes as they does not contain any sugar
Eat bananas as they are rich in water source with 70-80% of water
Prepare barley water or ragi wate, both contains enough vitamins, minerals and antioxidants to restore your body with energy
Take salt water daily and avoid alcohol consumption
Kidney disease is another common complication that occurs during diabetes. Dehydration during diabetes leads to the formation of kidney stones, urinary tract infections.
High blood glucose levels also called high blood sugar will damage the blood vessels in the kidney due to excessive pressure. The damaged blood vessels do not work properly leading to diabetic kidney disease or kidney failure.
Your urine will change to be dark-colored and you urinate less than usual. Depending on the age, climate, physical activity, gender, diseased state, or special condition like pregnancy you need to change the water intake.
Even the use of certain medications can cause kidney disease during diabetes which becomes more complicated. With increased blood sugar levels and increased blood pressure, there are more chances of developing kidney failure.
To manage this, you need to avoid-
Smoking
Salty foods
Skipping diabetes diet plan
Overeating
No exercise day
People with diabetes are more prone to heart diseases and other kidney diseases like polycystic kidney disease. So, the best way is to take more glasses of water, have regular check-ups on blood glucose levels, control blood pressure, healthy lifestyle, and regular medicine consumption.
Never neglect the water intake even if you are not a kidney patient, to avoid its occurrence in the future. Take steps to lower your blood glucose levels with a proper diet and medication.
Diabetic ketoacidosis and high blood glucose levels are acute metabolic complications caused due to diabetes mellitus. This can be resolved by fluid resuscitation, insulin therapy, and oral rehydration salts for diabetes.
The key symptoms of diabetic ketoacidosis include severe alteration of carbohydrate, protein, and lipid metabolism. The overall body shifts to a catabolic state due to the breakdown of glycogen stores, hydrolysis of triglycerides from adipose tissue, and mobilization of amino acids from muscles.
All these metabolites lead to the formation of glucose and ketone bodies by the liver. The increased blood glucose levels and ketone bodies are the cause of diabetic ketoacidosis.
Hyperglycemia also called diabetes or high blood sugar levels is caused due to three events-
a) increased gluconeogenesis
b) increased glycogenolysis
c) decreased glucose utilization by liver, muscle, and fat
The occurrence of insulinopenia and elevated levels of cortisol will lead to the formation of amino acids due to the shift of protein synthesis to proteolysis. These amino acids serve as substrates in the gluconeogenesis process.
The high levels of glucagon, catecholamines, and cortisol stimulate gluconeogenic enzymes that cause glucose production. The decreased glucose consumption and increased glucagon levels further lead to increased blood glucose levels in the body.
The hyperglycemic hyperosmolar state is one of the two dangerous complications of diabetes. Even though it is less common, it has a mortality rate of 5-10%.
The most common symptoms are infection, blood glucose levels reaching 600mg/dL or higher, excessive thirst, increased urination, fever, stroke, or myocardial infarction.
Diabetes insipidus is a condition where you need to urinate more frequently due to the deficiency of a hormone called vasopressin. Also called antidiuretic hormone, is controlled by the pituitary gland. Patients with diabetes insipidus produce 20 quarts of urine a day.
People with this disorder are called polyuria and as they urinate more and the condition is called polydipsia as they drink lots of water. In this condition, your kidney won’t function properly to concentrate urine leading to excess loss of water.
Signs of mild to moderate dehydration in diabetes insipidus may include-
Excessive thirst
Dry mouth
Dizziness or tiredness
Mental disability
Nausea
Severe dehydration will lead to seizures, brain damage, or death.
Excessive thirst and diabetes mellitus are associated together as dehydration will cause variation in blood sugar levels. When you are suffering from diabetes, your body will increase blood sugar levels due to insufficient insulin production.
To get rid of the excess blood glucose levels your kidney filters the blood so often and produces more urine than usual. This leads to excess loss of water causing severe dehydration. Chronic dehydration will eventually lead to kidney diseases like polycystic kidney disease and kidney failure.
This will make you thirstier during diabetic conditions. To avoid dehydration caused by diabetes mellitus you need to drink more glasses of water or use oral rehydration salts for diabetes. People with diabetes mellitus will get dehydrated easily compared to non-diabetic individuals.
To manage mild to moderate dehydration during diabetes mellitus, follow the steps below-
Drink more- Drink more water when you feel dizzy or exhausted after a task or in the middle of lunch. Dehydration can cause fluctuations in blood glucose levels all of a sudden.
Drink before needed- Drink water or take fluids even though you are not feeling thirsty, it is better to prevent the cause before it occurs.
Carry a water bottle- Never neglect to carry a water bottle with you. Small or big based on your time away from the water source try to keep a water container handy.
Take fluids in other forms- There is no need to take only water to stay hydrated, you can replace water with other juices or healthy drinks without sugar.
Avoid sugar- Reduce sugar from your diet and drinks. Stop drinking canned beverages or soda as they may contain some amount of sugar.
Regular test of blood glucose levels- Check the blood sugar levels daily to evaluate the rise in blood glucose levels. So that you can optimize your diet chart.
Exercise care- To work out, select a place under the roof. Or exercise under air conditioning or a fan to avoid dehydration caused by sweat.
Stay cool- Avoid trips or tours that include travel during warm sun or heat. This will increase the loss of water and cause dehydration in your body.
Reduce weight- Overweight will cause many risk factors like diabetes mellitus, dehydration is more in obese people due to excess blood glucose levels, sweat, and heat exhaustion.
Set a reminder- Use apps that remind you to drink when you are busy concentrating on doing work. There are many free apps available that can help you keep track of the number of glasses of water you drink.
Emergency kit- An emergency kit with sugar tablets, a blood test machine, medicines should always be with you to avoid complications like kidney failure and heat stroke.
Oral rehydration salts for diabetes- Oral rehydration salts for diabetes mellitus are very helpful to give instant energy without increasing blood glucose levels in your body.
Medicines- Proper use of medicines for diabetes mellitus will help you to control blood glucose levels and keep the blood sugar levels in check.
Your doctor may alter the medications regularly based on your blood sugar levels. So, you may experience changes in your body. Consult your doctor if you have severe symptoms of dehydration, dizziness, weak pulse, reduced blood pressure, and symptoms of diabetic thirst or diabetic ketoacidosis.
Drink enough water whether or not you are a diabetic person.
Never work hard in sun with no food or water because it may cause nausea, vomiting, and diarrhea leading to dehydration.
Always keep a sugar candy or sweet for immediate to improve sudden glucose drop in blood.
Wear a garment or sign that indicates your diabetes condition to people.
Inform your doctor even the slightest change in energy or tiredness you face.
If you ever need to go away from home try to carry a portable water bottle.
Start to say no to any kind of beverage offering as it contains sugar.
Avoid going into the hot sun in any case.
Stay hydrated by drinking more glasses of water or healthy juices.
Monitor your blood glucose levels regularly to keep in control.
Have sound sleep and meditate to get rid of stress and mental depression.
Exercise only in a cool place or under the roof, not outdoors, and never in a hot climate.
Consult a doctor if you feel dehydrated and pee less often.
Dehydration in diabetic patients leads to reduced blood pressure and secret stress hormones that raise blood sugar levels instantly.
Dehydration will cause an increase in the vasopressin hormone that stimulates the kidneys to retain water and the liver to increase blood sugar levels.
It is recommended to drink 13 glasses of water (3.08 liters) per day for men and 9 cups (2.13 liters) per day for women with diabetes.
To reduce the risk of kidney disease in diabetes you need to manage blood pressure, blood sugar levels, quit smoking, eat healthily and take medicines properly.
Take cinnamon, lemon wedges to drinks, pick fruits with less sweet and more fiber (berries), make your own treats, iced teas, and green juices.
During diabetes, excess glucose in the blood is forcefully eliminated by the kidneys to filter sugar leading to increased urination and dehydration.
Due to the absence of enough insulin in diabetic patients, the ketones are not metabolized through urine causing their accumulation in the bloodstream called diabetic ketoacidosis.
Polycystic kidney disease is an inherited disorder that causes cysts in the kidney due to kidney failure or kidney disease.
Over-the-counter drugs like Hydralyte and Pedialyte can be used along with oral rehydration salts for diabetes to reduce dehydration.
Severe dehydration can cause fever as the body doesn’t have enough water to regulate body temperature and lead to hyperthermia which is dangerous.
Headache is caused when your body doesn’t get enough fluids, this will go away within an hour if taken a few glasses of water.
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