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Overview of Diabetes Insipidus

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This condition is an imbalance of water due to a deficiency of anti-diuretic hormone (ADH) secreted from the pituitary gland or from insensitivity of the kidneys to ADH. Conditions that affect the posterior pituitary gland and the neurohypophyseal tract limit the secretion of ADH. This condition leads to the excretion of large amounts of diluted urine. Individuals with this condition may become dehydrated, leading to fatigue and irritability.1 This condition is not related to diabetes mellitus, which affects insulin levels. The deficiency of or insensitivity to ADH does not directly affect an individual's endurance or cardiovascular response to exercise.

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Comorbidities to Consider

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  • Dehydration and polyuria may affect the individual's ability to carry out an effective exercise program.

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Client Examination

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Keys to Examination of Clients

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  • Ask clients about test results for ADH levels, urine volume, urine concentrations of water to solutes, and tests of blood plasma concentrations.

  • Closely monitor hydration levels before, during, and after exercise.

  • Ask clients if they take the medication desmopressin, which is an artificial form of ADH.

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Recommended Baseline Testing of Fitness Levels

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  • Assess for aerobic capacity using walking, running, or cycle ergometer tests.

  • Determine if other assessments for muscle strength, body fat measures, and risk for heart disease are needed.

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Exercise Prescription

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Type: Variety of aerobic and recreational activities

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Intensity: Moderate to high intensities

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Duration: 30–50 minutes

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Frequency: Five to seven times per week

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Getting Started

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Clients are not restricted in the type of exercise they choose as long as they maintain their hydration. Low-sodium diets help control hydration levels. Exercise programs need to include access to hydration and restrooms. Resistive exercises performed twice per week, using 8 to 12 repetitions that produce a volitional fatigue, are recommended for adults.2 Clients should be encouraged to maintain a regular exercise program and a healthy lifestyle throughout their life span.3

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References

1. +
National Diabetes Insipidus Foundation. http://www.ndif.org/pages/6-Diagnosis_Treatment. Accessed May 26, 2009.
2. +
Haskell  WL, Lee  IM, Pate  RR,  et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39(8):1423–1434, 2007.  [PubMed: 17762377]
3. +
Diabetes Insipidus Foundation. http://www.diabetesinsipidus.org/4di_gear_up_for_sports.htm. Accessed May 26, 2009.

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