linical_Approach_Polyuria_Polydipsia_Polyphagia_Updated[1].pptx

How to approach a patient having polyuria polydipsia and polyphagia

1. Clinical Approach to a Patient with Polyuria, Polydipsia, and Polyphagia A Systematic Diagnostic and Management Guide Presented by: Abdul Haseeb Roll No: 137 Group: Beta Date: [ 08/03/2025 ]

2. Introduction • Polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (excessive hunger) are classic symptoms of metabolic disorders. • Most commonly associated with diabetes mellitus but can indicate other conditions. • A stepwise clinical approach helps in timely diagnosis and management.

3. Common Causes • Diabetes Mellitus (Type 1 & Type 2) • Diabetes Insipidus (Central or Nephrogenic) • Hyperthyroidism • Cushing’s Syndrome

4. History Taking • Onset & Duration: Gradual vs. sudden? • Associated Symptoms: - Weight loss? (Suggests uncontrolled diabetes or hyperthyroidism) - Blurred vision? (Diabetes-related complications) - Nocturia? (Diabetes insipidus or hypercalcemia) • Family History: Diabetes, endocrine disorders • Medication History: Diuretics, lithium, steroids • Lifestyle Factors: Diet, fluid intake, stress

5. Physical Examination • General: BMI, hydration status, signs of weight loss or obesity • Vitals: Blood pressure, pulse • Skin & Nails: Acanthosis nigricans (Diabetes), moon face & striae (Cushing’s) • Neurological Exam: Altered mental status in hyperglycemia/hypercalcemia

6. Initial Laboratory Workup 1. Blood Glucose (Fasting & Random), HbA1c – Diabetes Mellitus 2. Serum & Urine Osmolality – Diabetes Insipidus vs. Psychogenic Polydipsia 3. Serum Electrolytes (Na, K, Ca) – Hypercalcemia, Hypokalemia 4. Thyroid Profile (TSH, FT4, FT3) – Hyperthyroidism 5. Cortisol Levels (AM Cortisol, ACTH, Dexamethasone Suppression Test) – Cushing’s vs. Addison’s 6. Urinalysis & Urine Glucose/Ketones – Diabetes, Infection 7. Water Deprivation Test – Differentiating central vs. nephrogenic DI

7. Interpretation of Findings • High blood glucose, HbA1c >6.5% → Diabetes Mellitus • Low urine osmolality despite dehydration → Diabetes Insipidus • Hypernatremia, low ADH → Nephrogenic DI • High cortisol, abnormal dexamethasone suppression test → Cushing’s Syndrome • Low TSH, high T4/T3 → Hyperthyroidism

8. Management Approach • Diabetes Mellitus: Lifestyle changes, oral hypoglycemics (Type 2), insulin (Type 1) • Diabetes Insipidus: Desmopressin (Central DI), thiazides (Nephrogenic DI) • Cushing’s Syndrome: Treat underlying cause (Tumor removal, medication) • Hyperthyroidism: Antithyroid drugs, beta-blockers, radioactive iodine • Psychogenic Polydipsia: Behavioral therapy, psychiatric evaluation

9. Case Scenarios & Discussion • Example: A 25-year-old with polyuria, polydipsia, weight loss, and fasting glucose of 280 mg/dL → Likely Type 1 Diabetes

10. Differential diagnosis 1) Diabetes mellitus type 1 2)Diabetes mellitus type 2 3)Diabetes insipidus Central Nephrogenic 4) Hyperthyroidism 5) Cushing's   syndrome

11. Conclusion • Polyuria, polydipsia, and polyphagia require systematic evaluation to determine the underlying cause. • Diabetes mellitus is the most common cause, but other endocrine/metabolic disorders must be considered. • Early diagnosis and targeted management prevent complications.