Polyuria or excessive production of urine – more than 3 liters a day versus 1 to 2 liters of normal daily urine output in adults – is an accompanying symptom of diabetes. The condition makes sugar build up in the blood stream. The kidneys filter blood to produce urine and reabsorb sugar, returning it to the bloodstream. However, in diabetes mellitus, the levels of sugar in blood become abnormally high and kidneys cannot reabsorb all the sugar. So, the excess sugar from the blood is excreted in the urine where it draws more water. This results in excessive urine output, which may lead to severe dehydration.
Dehydration, in its turn, can make you feel extremely thirsty. As a result, the more you urinate, the thirstier you feel – a condition called polydipsia. And as you drink more liquids to quench your thirst, the more you urinate.
Both polyuria and polydipsia are considered the earliest symptoms of diabetes. They can appear simultaneously, the latter being a cause or an effect, or it is possible to have one without the other. Although, they are most common in diabetes mellitus, they can also be specific to diabetes insipidus – a rare condition not related to diabetes mellitus that affects kidneys and hormones that interact with them, bringing about large quantities of urine output. In other words, in diabetes insipidus your body cannot control its levels of fluid and you may constantly feel very thirsty no matter how much you drink. And the more you drink, the worse your polyuria gets.
Polyuria can also be a result of:
- Medications, such as diuretics, SSRI antidepressants, calcium channel blockers and tetracycline antibiotics
- Chronic diarrhea
- Kidney or liver disease
- Cushing’s syndrome
- Psychogenic polydipsia (specific to anxious middle-aged women and psychiatric patients)
The most common sign of polyuria is producing abnormally large volumes of urine at regular intervals of time. It can also wake you up at night, as the urge doesn’t stop when you sleep.
If you are concerned how much urine your body produces, make a note of how much you drink, how often you urinate and how much urine you excrete each day and every time you go to the bathroom.
If you notice excessive urination for several days, which cannot be attributed to medication or drinking too much caffeinated or alcoholic beverages, consult your doctor to find out the cause. It can be a symptom of undiagnosed diabetes or other condition.
If you have already been diagnosed with diabetes, measure your blood glucose, as it can be a sign that your sugar levels have risen too high. If this is the case, you may need to change your treatment plan to get your diabetes under control.
Although, polyuria is not as serious as other complications of diabetes, such as kidney failure, stroke, eye and heart problems, it is something you should necessarily address with your endocrinologist to avoid all the possible further complications listed above.
Besides simply being a matter of achieving better diabetes control, they may recommend consulting with an urologist.
Frequent urination in people with diabetes may also indicate a urinary tract or fungal infection, which may lead to increased urinary frequency, especially in elderly patients.
If diabetes is poorly controlled or gets worse, the sugar can begin to damage the nerves around the bladder, leading to bladder dysfunction, called neurogenic bladder. This condition is similar to neuropathy that causes numbness or tingling in the feet. In such case, the nerve damage prevents the bladder form fully emptying, causing frequent urges to urinate.
That’s why the earlier your condition is diagnosed, the sooner treatment can be started.