Polyuria, the production of an abnormally large amount of urine, is commonly associated with diabetes. 

Polyuria is a fairly common condition. However, excessive urination is one of the main symptoms people with diabetes report before they are diagnosed. 

Many people with diabetes will also experience polyuria at times even after their diagnosis.

This article will investigate the causes of polyuria and its connection with diabetes. 

Diabetes and Polyuria (Frequent Urination)

What is polyuria?

Polyuria is the medical term for when a person is producing excessive urine. 

Excessive urination is usually noticed either when someone urinates more often than what is normal for them, or if they have more urine in their bladder each time they urinate than is typical. 

However, urinary frequency and urinary urgency are both different symptoms from polyuria. Polyuria relates specifically to the total volume of urine produced by the body.

Polyuria should always be reported to your doctor or medical provider, especially if it is not explained fully by a condition you are already aware you have. 

Polyuria can also be related to nocturia, which is a medical term for needing to get up more than once per night to go to the bathroom.

How much urine is considered polyuria?

Medical professionals define polyuria in terms of the total amount of urine a person produces in a day.

If someone is drinking a normal amount of liquid – about 2 liters or 68 oz liquid per day – then a normal amount of urine to produce is 800 mL to 2 liters of urine.  

However, numerous factors from exercise to outside temperature and humidity, to medications and coffee intake can impact these figures, and it is not always a diagnosable condition. People also may urinate more or less, depending on their level of hydration. 

For an adult, the National Library of Medicine considers polyuria the production of more than 2.5 liters (68 ounces – or just over 2.5 quarts) of urine in a 24-hour period. 

Some people with undiagnosed diabetes may urinate up to 15 liters of liquid per day, which is an extreme case of polyuria, but it is possible.

How often is too often to pee?

First, there is no set amount of times per day that someone should or should not pee. However, on average, a typical person pees between 6-7 times per day. 

People can urinate anywhere between 4-10 times per day and it can be considered healthy if it is not interfering with everyday life. However, people with polyuria, because they’re producing more urine than normal, will also pee more often than normal. 

Peeing on average more than 10 times per day may be considered polyuria, especially if it is a nuisance to your schedule and life. 

If you’re urinating more often than normal, or more than once per night, and you’re producing a large amount of urine each time you pee, you may want to talk with your doctor. 

If you’re peeing frequently but it is not productive, you may be experiencing a prostate issue (for males only), and may also want to talk with your doctor.

What are the symptoms of polyuria? 

The symptoms of polyuria include: 

  • Urinating more than usual
  • Urinating more frequently than usual 
  • Getting up more than once per night to urinate 
  • Feeling like you have to urinate immediately after using the bathroom 
  • Feeling like you’re not completely emptying your bladder, even during and immediately after using the bathroom 

What are the most common causes of polyuria?

Polyuria is a symptom of several conditions, including:

  • Undiagnosed type 1 diabetes, type 2 diabetes, gestational diabetes, or prediabetes
  • High blood sugar levels in people with diagnosed diabetes 
  • Diabetic ketoacidosis (DKA) 
  • Ketosis, especially in combination with high blood sugar levels, or when someone is first in ketosis at the start of a ketogenic diet 
  • Damage to the kidney, either from disease, infection, or a physical injury
  • Sickle cell disease
  • Liver disease
  • An overactive bladder
  • An enlarged prostate or other prostate issues (in males)
  • Urinary tract infection (UTI)
  • Pregnancy
  • Certain prescription drugs

At its most benign, polyuria can also be a result of simply drinking a large amount of liquid, though in these cases, it will go away when your liquid intake returns to normal.

Why does diabetes cause polyuria?

Diabetes, most often undiagnosed diabetes, causes polyuria due to high blood sugar levels. 

When the body either doesn’t have enough insulin or has no insulin in the bloodstream, cells cannot digest glucose from the food that’s eaten. When that glucose spills over into the bloodstream, it creates high blood sugar levels.

When blood sugar levels remain high, your kidneys produce more urine to try to flush the extra glucose from the body. 

This cycle also causes the classic diabetes symptom of excess thirst; since people with undiagnosed diabetes are urinating so much, the brain tells the body to drink more in order to replace all the fluids being lost. 

This can be a dangerous cycle if someone’s blood sugar levels do not come down quickly. If you’re struggling with both excess thirst and excess urination and you do not have diagnosed diabetes, call your doctor immediately.

If you’re experiencing both excess urination and excess thirst and have diagnosed diabetes, check your blood sugar immediately and check for ketones. 

If your blood sugar is dangerously high and you have moderate or high ketones, call your doctor immediately. 

Having diabetes by itself does not cause polyuria; high blood sugars do. If you have high blood sugar levels and are urinating more than normal, once you take insulin (or any other prescribed diabetes medication), and your blood sugar levels come back down to normal, polyuria will typically go away.

Conclusion

Polyuria is a condition in which the body produces an excessive amount of urine. It is actually a symptom of many different conditions, including undiagnosed diabetes, high blood sugar levels in diagnosed diabetes, diabetic ketoacidosis, pregnancy, a kidney infection, urinary tract infection, or even prostate issues. 

The typical person urinates no more than 2 liters per day, and usually between 6-8 times per day. However, someone with polyuria may urinate over 15 liters per day, and many times throughout both the day and night. 

If you are experiencing the symptoms of polyuria, including an increased amount of urine (with no underlying cause like excess water or coffee intake), increased frequency of urination, feeling the need to use the bathroom all the time, or getting up multiple times throughout the night to use the bathroom, you may want to talk with your doctor about your symptoms. 

Diabetes is a common cause of polyuria due to untreated high blood sugar levels in the bloodstream. When the body lacks insulin, blood glucose goes up, and the kidneys produce more urine to try and flush the body of the excessive sugar. 

This can quickly lead to dehydration and another classic diabetes symptom, excessive thirst. 

If you suspect you have undiagnosed diabetes, or you have diagnosed diabetes and are experiencing these symptoms, check your blood sugar right away, and ideally, check for ketones as well. 

If blood sugar levels are not brought back down into a normal range, diabetic ketoacidosis (DKA) can develop, which can be potentially life-threatening.