Nocturnal Polyuria...Lipodystrophy?

Do you have diabetes?

Antje77 said:

Do you have diabetes?

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Diabetes mellitus that is (the main types being type 1 and type 2), since diabetes insipidus has been ruled out. Hope you don’t mind me just making that clarification @Antje77 ?

This article might be helpful:- https://my.clevelandclinic.org/heal...tion in,reduce symptoms of overactive bladder.

Happy-go-lucky said:

Hi , thank you for your reply. I really don't know if its type 1 or 2. My last blood glucose test was 4.8 so the doctor said its not diabetes.

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If your hba1c was 4.8 your doctor is right and you do not have diabetes mellitus of whatever type.

Happy-go-lucky said:

However , I feel that I've got severe insulin resistance and peeing up to 10 times a night is not normal.

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Why do you feel you have insulin resistance?
The peeing in diabetics is a result of having high blood glucose, and when our blood glucose goes back to normal (through diet changes, medication or insulin) the excessive peeing stops. So excessive peeing is not a sign of diabetes if your blood glucose isn't high.

Happy-go-lucky said:

That's why I'm thinking lipodystrophy.

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I'm puzzled on the lipodystrophy, what makes you think you have this?

Happy-go-lucky said:

Hi, As I understand it you can have normal blood sugars and still have hyperinsulimia so you are essentially diabetic .....super high insulin levels and by the time your blood sugar is out of control you've been diabetic for posdibly decades

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True!
But this doesn't make you pee more, it's elevated blood glucose which does that.

Please note I am NOT a doctor, so I am not diagnosing - but from experience, mild urinary infections that don't even hurt can be the devil to clear up as we often need two different types of antibiotic - one aerobic and one anaerobic. Not all GPs seem to realise this. Do you have fluid retention in your legs, is your heart working okay, are you taking any meds?

A proper diagnosis after tests is the way to go, and for maintenance I take cranberry capsules. They may or may not work, but I haven't had problems in a long time, and they do no harm. But up to you.

I've also had to cope with those middle-of-the-night toilet runs - it's exhausting I know. In my case, I have an enlarged prostate and a flow test showed there was obstruction so my bladder rarely emptied completely. Last summer I wondered if diabetes could also be part of the problem and requested a blood test however the results were normal.
Then, a month ago (just before I was scheduled for a laser procedure to sort out the obstruction from the prostate) a blood test showed uncontrolled diabetes! Looking back, a lot of my diabetic symptoms were present last year even though diabetes didn't show in the bloods.
Other early symptoms for me were breathlessness, rapid weight gain (without dietary change I went from 88kg to 120kg in about 10 months), intense hunger whether or not I'd eaten and the need for frequent naps (even falling asleep mid-conversation) after meals. I didn't notice any particular thirst (I was used to controlling how much liquids I drank due to bladder problems).
My diet over the last 30-40 years has been mostly vegetarian and very carb heavy (the so-called good carbs, complex and rich in fibre). Now I'm trying to reduce that right down and testing with a blood sugar metre to give me feedback. I'm hoping that at my next HbA1c the blood sugar will be low enough that I can have my surgery and finally get an uninterrupted night's sleep!
The sugar levels do seem to be reducing, I'm losing weight and I'm not feeling hungry. I do miss my favourites of toast for breakfast with Marmite and marmalade or a large bowl of porridge! Oh, and beans on toast, and dunking biscuits in my tea or coffee!

Lobsang Tsultim said:

Last summer I wondered if diabetes could also be part of the problem and requested a blood test however the results were normal.

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Did they tell you what your hba1c was at the time? Some doctors call it 'normal' if you're high in the pre-diabetic zone, which may mean an average BG of close to 8mmol/l. With that average, it's likely to be much higher at night, when your evening meal and maybe snacks are being digested, and which does make you pee more.

@Happy-go-lucky 's hba1c of 4.8% (or 29 mmol/mol) is a very non diabetic number, corresponding to an average BG of 5 mmol/l.

A lot of people seem to think that if you have high blood sugar you need to wee more. This can’t apply to everybody! If my blood sugar is high I don’t need to keep going to the loo. I was put on empaglaflozin and was told to expect more trips to the toilet, didn’t effect me in that way at all. When I was diagnosed I didn’t have the usual symptoms. I just had repeated thrush a few times and it was picked up from that. I never find I’m that thirsty either.

Antje77 said:

Did they tell you what your hba1c was at the time? Some doctors call it 'normal' if you're high in the pre-diabetic zone, which may mean an average BG of close to 8mmol/l. With that average, it's likely to be much higher at night, when your evening meal and maybe snacks are being digested, and which does make you pee more.

@Happy-go-lucky 's hba1c of 4.8% (or 29 mmol/mol) is a very non diabetic number, corresponding to an average BG of 5 mmol/l.

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It was 41, so top of the normal range. I normally didn’t eat after around 3pm. Typically my food intake was between 0800 and 1300, i.è. Breakfast and lunch.

Sarah69 said:

A lot of people seem to think that if you have high blood sugar you need to wee more. This can’t apply to everybody! If my blood sugar is high I don’t need to keep going to the loo. I was put on empaglaflozin and was told to expect more trips to the toilet, didn’t effect me in that way at all. When I was diagnosed I didn’t have the usual symptoms. I just had repeated thrush a few times and it was picked up from that. I never find I’m that thirsty either.

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I was exactly the same, no other symptoms. Mine was picked up through the repeated thrush. I am so glad I don't get the repeated thrush now - it was vile

Some wee sticks would tell you if you have glucose in your wee. Normally we only wee out glucose when our blood sugar gets to around 10 mmol/l which would give you a higher test result than 4.8.

As a detour but possibly of help I found that having a Hepa air purifier beside me on the floor by the bed stopped my nightly excursions. I now sleep through to 10 am and if I do wake early then it is about 7 am. I am retired now so getting up in the morning is not such a necessity any more.

Good clear write up, definitely not diabetes related

Have you consulted a urologist at any stage ?That would be my next port of call were I you

Happy-go-lucky said:

It feels like everything I have eaten at my evening meal I pee out all night and start all over again in the morning. I tried fasting in the morning time and it didn't work for me......I was shattered from the night before and felt much better having a light breakfast, some eggs. A ,ot of people assume because you are lean you are healthy and this can be a big mistake. People with FPL or CGL are all severely insulin resistant and most are diabetic. I'm convinced that I've got FPL and would love to prove it for my own satisfaction......although I would still have the challenge at nighttime.

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when you get up to pee, is your bladder full each time, is there a significant amount of urine to match your need to pee? an enlarged prostate for example would mean incomplete bladder emptying with urgency.

Given that we can only pee out what we take in, how much fluid do you have a day and how often do you pee during the day and what sort of amount are you peeing?

there could be many conditions causing your problem. Even being cold at night and waking up several times, triggering a sense of bladder urgency can cause this.