“Is frequent urination a symptom of type 1 diabetes?”
I noticed that my daughter has been going to the bathroom to pee. Like 4-5 times a day. She's also drinking a lot. Is frequent urination a symptom of type 1 diabetes?
4 Answers
Frequent urinations could caused by many reasons. She needs to be seen in any medical office. Simple urine test could release your worries.
Urination is a complex process that involves neuronal and muscular coordination of the bladder in order to urine from the bladder. Urine is formed in the kidneys and stored in the bladder. The kidneys filter about 150 liters of blood every day. About 20% of the cardiac out put is filtered at any given time. About 99% of the filtered blood is reabsorbed to the blood from the kidneys filtration system. Only about 1% of the total filtrate is excreted as a urine. Urine is acidic about 6 pH. Urine formation is the process of eliminating organic waste products produced from the cellular mechanism of the body. The urination process maintains normal, blood volume, body's pH, blood pressure and electrolytes.
The bladder is the storage of urine formed in the kidneys. It usually holds about 500ml though it can go up to 1000ml. When the bladder contains 250-400 ml the bladder walls expand stimulating stretch receptors. These causes stimulation of neuronal reflexes (autonomic) in the lower spine area (sacral area) allowing the contraction of the bladder detrusor muscle to contract and open the internal sphincter of the bladder. Higher centers in the brain get activated from the spinal reflexes and stimulate the pudendal nerve to allow the external sphincter of the bladder to relax and allow urine flow out of the bladder. The internal sphincter is under spinal reflex and is involuntary. when the bladder senses fullness this sphincter opens involuntarily. The external sphincter is under a voluntary control. This does not mature until the toile training age of 3 years. Before the age of three years urination is involuntary and needs to have a diaper. After the age of 3 years when the higher brain centers mature we can control the external sphincter voluntarily and urinate in our convenient time. Patients with spinal cord lesion may have only involuntary micturition since massage to the higher centers can not be relayed through the spinal cord.
Generally we urinate about 300-500ml at each micturition. The average person urinates about 1-2 liters a day. This will be about 4-8 trips to the bathroom daily. However there is a big variation from person to person. Some people drink a lot some drink less. The type of drinks and the weather condition and our medical conditions affect how much we drink and how much we urinate. Drinking caffeinated and alcoholic drinks, and cold weather will make us urinate more frequently. Hot weather and low fluid intake will make us micturate less often.
Generally over 3000 ml (3 liters) a day and more than 8 trips to the bathroom should be of concern if there is a disturbance in quality of life. If it is not disturbing quality of life it most likely is normal.
Children have small bladder and urinate more frequently than adults.
Abnormal urination could be due to pathology in the kidneys or the bladder. Since urine is formed and concentrated in the kidneys any abnormalities in the kidney's ability to concentrate urine will reflect in the quantity, frequency and quality of urination. Any problems that affect the bladder can also affect the frequency of urination. Since hormones, neurons and muscle are involved in urination any abnormality in these elements will affect the frequency or urgency of urination.
There are several causes of frequent urination that may disrupt quality of life due to frequent visit to the bathroom or frequent waking up at night to urinate.
1) Caffeine or alcohol. Can cause urges to urinate. They act as diuretics. When the bladder if full the urge to go to relieve the void is irresistible.
2) Some people are habitual drinkers. These are people that drink plenty of fluid a day and go to the bathroom more often.
3) Diabetes mellitus: In newly onset diabetes or uncontrolled diabetes high blood sugars spills to the urine. When there is a lot of sugar in the urine water follow the urine by osmotic gradient from the kidneys. Usually blood sugars above 180 mg/dl are excreted in the urine in order to lower the osmotic load of the body. This causes copious urine and frequent urination including nocturnal.
4) Diabetes Insipidus: patients with this disorder produce excess urine and urinate very often. A hormone called antidiuretic hormone is either deficient or the kidneys are resistant to it and it does not function. Under normal condition this hormone helps reabsorb about 10% of the water in the kidneys filtrate. Lack or in effectiveness of this hormone causes the kidney to loss 10% of the water that should have been reabsorbed to maintain the blood volume and blood pressure and
electrolytes. These patients can urinate up to 15 liters per day and prefer cold water than any drink.
5) Dipsogenic diabetes insipidus: This patients drink and urinate a lot though they do not have hormone problems. they probably have either damage to their thirsty mechanism in the hypothalamus or have psychiatric issues.
6) Hypercalcemia: Hypercalcemia is mostly due to excess hormone production call parathyroid hormone or multivitamin supplements or vitamin D toxicity. High calcium in the body causes diuresis due to osmotic drugging of water. It also causes kidney stones and blood in the urine, constipation and other nerve problems.
7) Pregnancy: Pregnancy can cause pressure to the bladder to contract and urinate more often.
8) Medications: Diuretics are a good example that may cause frequent urination.
9) Other causes are: bladder infection, bladder injury, structural anomalies of the bladder, bladder cancer, anxiety, kidney stones etc.
Other associated symptoms with frequent urination are: difficult urinating in the presence of an urge to urinate, pain while urinating urine, bloody urine, cloudy smelly urine, urinary incontinence, discharge, fever, thirsty, abnormal heart beat etc.
Any frequent urination that have other accompanying symptoms that disrupts the quality of life should be evaluated and treated appropriately. Urine and blood sugars need to be tested to rule out diabetes mellitus. A detailed history and physical and the accompanying clinical symptoms will uncover the possible diagnosis is most cases. Early medical evaluation is very essential for those with frequent urination and disturbance in quality of life.
Going back to your Daughters: Your daughter urinates about 4-5 times a day which is a normal frequency especially in a child who has a smaller bladder. Children urinate more often than adults. Usually any thing above 7-8 micturition a day would be of a concern especially if this is recent and is disrupting the quality of life. But is there is a family history of diabetes and if you have suspicion it would not hurt to check her out for diabetes. You can see her doctor and discuss your concern with her doctor. The doctor can order simple things such as fasting blood sugar, HbA1c and urine glucose and urinalysis. If she continues to urinate more frequently and there are no other symptoms such as pain, fever or hesitancy when urinating let the doctor check her for diabetes insipidus of any of the causes. But if there is no other disturbances and she is just urinating 4-5 times a day a watchful monitoring would be another option. But make sure she does not have urinary tract infection if there are other clues.
See your doctor and discuss these issues in detail. He will relate your concern to the physical exam and perform the necessary steps.
Good Luck
The bladder is the storage of urine formed in the kidneys. It usually holds about 500ml though it can go up to 1000ml. When the bladder contains 250-400 ml the bladder walls expand stimulating stretch receptors. These causes stimulation of neuronal reflexes (autonomic) in the lower spine area (sacral area) allowing the contraction of the bladder detrusor muscle to contract and open the internal sphincter of the bladder. Higher centers in the brain get activated from the spinal reflexes and stimulate the pudendal nerve to allow the external sphincter of the bladder to relax and allow urine flow out of the bladder. The internal sphincter is under spinal reflex and is involuntary. when the bladder senses fullness this sphincter opens involuntarily. The external sphincter is under a voluntary control. This does not mature until the toile training age of 3 years. Before the age of three years urination is involuntary and needs to have a diaper. After the age of 3 years when the higher brain centers mature we can control the external sphincter voluntarily and urinate in our convenient time. Patients with spinal cord lesion may have only involuntary micturition since massage to the higher centers can not be relayed through the spinal cord.
Generally we urinate about 300-500ml at each micturition. The average person urinates about 1-2 liters a day. This will be about 4-8 trips to the bathroom daily. However there is a big variation from person to person. Some people drink a lot some drink less. The type of drinks and the weather condition and our medical conditions affect how much we drink and how much we urinate. Drinking caffeinated and alcoholic drinks, and cold weather will make us urinate more frequently. Hot weather and low fluid intake will make us micturate less often.
Generally over 3000 ml (3 liters) a day and more than 8 trips to the bathroom should be of concern if there is a disturbance in quality of life. If it is not disturbing quality of life it most likely is normal.
Children have small bladder and urinate more frequently than adults.
Abnormal urination could be due to pathology in the kidneys or the bladder. Since urine is formed and concentrated in the kidneys any abnormalities in the kidney's ability to concentrate urine will reflect in the quantity, frequency and quality of urination. Any problems that affect the bladder can also affect the frequency of urination. Since hormones, neurons and muscle are involved in urination any abnormality in these elements will affect the frequency or urgency of urination.
There are several causes of frequent urination that may disrupt quality of life due to frequent visit to the bathroom or frequent waking up at night to urinate.
1) Caffeine or alcohol. Can cause urges to urinate. They act as diuretics. When the bladder if full the urge to go to relieve the void is irresistible.
2) Some people are habitual drinkers. These are people that drink plenty of fluid a day and go to the bathroom more often.
3) Diabetes mellitus: In newly onset diabetes or uncontrolled diabetes high blood sugars spills to the urine. When there is a lot of sugar in the urine water follow the urine by osmotic gradient from the kidneys. Usually blood sugars above 180 mg/dl are excreted in the urine in order to lower the osmotic load of the body. This causes copious urine and frequent urination including nocturnal.
4) Diabetes Insipidus: patients with this disorder produce excess urine and urinate very often. A hormone called antidiuretic hormone is either deficient or the kidneys are resistant to it and it does not function. Under normal condition this hormone helps reabsorb about 10% of the water in the kidneys filtrate. Lack or in effectiveness of this hormone causes the kidney to loss 10% of the water that should have been reabsorbed to maintain the blood volume and blood pressure and
electrolytes. These patients can urinate up to 15 liters per day and prefer cold water than any drink.
5) Dipsogenic diabetes insipidus: This patients drink and urinate a lot though they do not have hormone problems. they probably have either damage to their thirsty mechanism in the hypothalamus or have psychiatric issues.
6) Hypercalcemia: Hypercalcemia is mostly due to excess hormone production call parathyroid hormone or multivitamin supplements or vitamin D toxicity. High calcium in the body causes diuresis due to osmotic drugging of water. It also causes kidney stones and blood in the urine, constipation and other nerve problems.
7) Pregnancy: Pregnancy can cause pressure to the bladder to contract and urinate more often.
8) Medications: Diuretics are a good example that may cause frequent urination.
9) Other causes are: bladder infection, bladder injury, structural anomalies of the bladder, bladder cancer, anxiety, kidney stones etc.
Other associated symptoms with frequent urination are: difficult urinating in the presence of an urge to urinate, pain while urinating urine, bloody urine, cloudy smelly urine, urinary incontinence, discharge, fever, thirsty, abnormal heart beat etc.
Any frequent urination that have other accompanying symptoms that disrupts the quality of life should be evaluated and treated appropriately. Urine and blood sugars need to be tested to rule out diabetes mellitus. A detailed history and physical and the accompanying clinical symptoms will uncover the possible diagnosis is most cases. Early medical evaluation is very essential for those with frequent urination and disturbance in quality of life.
Going back to your Daughters: Your daughter urinates about 4-5 times a day which is a normal frequency especially in a child who has a smaller bladder. Children urinate more often than adults. Usually any thing above 7-8 micturition a day would be of a concern especially if this is recent and is disrupting the quality of life. But is there is a family history of diabetes and if you have suspicion it would not hurt to check her out for diabetes. You can see her doctor and discuss your concern with her doctor. The doctor can order simple things such as fasting blood sugar, HbA1c and urine glucose and urinalysis. If she continues to urinate more frequently and there are no other symptoms such as pain, fever or hesitancy when urinating let the doctor check her for diabetes insipidus of any of the causes. But if there is no other disturbances and she is just urinating 4-5 times a day a watchful monitoring would be another option. But make sure she does not have urinary tract infection if there are other clues.
See your doctor and discuss these issues in detail. He will relate your concern to the physical exam and perform the necessary steps.
Good Luck
Yes, increased urination may be one of the symptoms of diabetes mellitus.
Yes, these signs could be Type 1 diabetes. Get it checked. There are many reasons for thirst & urination, but certainly diabetes is the most common. The signs to look for are "polydipsia" (excess thirst), "polyuria" (excess urination), and "polyphagia" (excess hunger usually associated with wt. loss). See a Dr. right away since if it is diabetes, the earlier treatment is started, the better. Untreated, this can lead to death. Likewise, if you get it tested & it is not diabetes, you can have peace of mind.
