2018 Volume 61 Issue 5 Pages 323-329
A 26-year-old man was referred to our hospital due to hyperglycemia. He had been diagnosed with autism spectrum disorder in 2002. Since 2010, he had drunk 6 to 12 L of sugar-sweetened beverages every day. The amount of polydipsia had gradually decreased due to the adjustment of psychiatric medications, but in July 2016, he showed weight loss and was found to be in a hyperglycemic state. His plasma glucose level was 377 mg/dL, and his HbA1c was 16.9 %. Furthermore, ketone bodies were positive on a urine test, so he was diagnosed with soft-drink ketosis. Insulin therapy was started, and his blood glucose level gradually decreased. He stopped drinking sugar-sweetened beverages after the diagnosis of diabetes mellitus, and all glucose-lowering medications were able to be stopped soon after. However, his polydipsia was persistent, and a decrease in his antidiuretic hormone release (ADH) was confirmed, although his polydipsia had initially been thought to be merely psychogenic. The administration of desmopressin was started, which improved his polydipsia. Long-term polydipsia may cause the down-regulation of ADH, so it is important to diagnose and treat polydipsia properly in patients consuming sugar-sweetened beverages, as such treatment can prevent the development of diabetes mellitus or improve their glycemic control.
