Diabetes Insipidus

What is diabetes insipidus ?

Diabetes insipidus is a rare condition in which the body's fluids become unbalanced. This causes the body to produce huge quantities of urine. It also makes you feel extremely thirsty, even after drinking something. Diabetes insipidus is also known as arginine vasopressin deficit or resistance.

Although the names "diabetes insipidus" and "diabetes mellitus" seem similar, they are not related. Diabetes mellitus is characterised by elevated blood glucose levels.

What causes diabetic insipidus?

It is often caused by deficiency of vasopressin, a hormone that helps your kidneys regulate the quantity of fluid in your body.

Symptoms

Diabetes insipidus in adults manifests as extreme thirst, pale urine, and frequent night time urination. Children may experience heavy, wet diapers, pale urine, bedwetting, weight loss, poor growth, vomiting, irritability, fever, constipation, headache, sleep problems, and vision issues.

Adults normally urinate approximately 1 to 3 liters each day. People with diabetes insipidus who drink a lot of fluids may produce up to approximately 19 liters of urine per day.

Types of diabetes insipidus

There are four types of diabetes insipidus: Central diabetes insipidus: It is the most common type of diabetes insipidus that occurs when the body lacks enough antidiuretic hormone (ADH) or vasopressin. Nephrogenic diabetes insipidus: It occurs when the pituitary gland releases enough ADH but the kidneys cannot retain water. Dipsogenic diabetes insipidus: This occurs due to a hypothalamic problem unrelated to the synthesis of ADH. People with this kind of diabetes insipidus have increased thirst and fluid intake that results in the need to urinate often. Gestational diabetes insipidus: It is a rare, temporary condition that develops during pregnancy and usually disappears after the pregnancy.

Diagnosis

A water deprivation test is a reliable method for diagnosing diabetes insipidus, which involves not drinking liquid for several hours. Other tests may include blood tests to check antidiuretic hormone (ADH), and glucose levels, urinalysis to check osmolality, and imaging tests like MRI to rule out other conditions.

Management

Desmopressin is the first-line treatment for central diabetes insipidus taken as injections, pills, or nasal sprays. It is also used to treat gestational diabetes insipidus. Treatment for nephrogenic diabetes insipidus involves thiazide diuretics and NSAIDs, with the right combination sometimes needed. Dipsogenic diabetes insipidus treatment is still unknown, but if underlying conditions cause it, treatment may involve addressing that cause.