Diabetes insipidus (pronounced die-uh-BEE-teze in-SIP-uh-dus) is a rare condition that disrupts the body’s fluid balance, leading to excessive urine production and persistent thirst, even after consuming fluids. It is also known as arginine vasopressin deficiency and arginine vasopressin resistance.
Although the terms “diabetes insipidus” and “diabetes mellitus” may appear similar, these two conditions are unrelated. Diabetes mellitus involves high blood sugar levels, and it’s a prevalent condition often referred to simply as diabetes.
While there is no cure for diabetes insipidus, treatments are available to alleviate its symptoms. These treatments aim to alleviate thirst, reduce urine production, and prevent dehydration.
Diabetes Insipidus Symptoms
Adult symptoms include:
- Intense thirst, often favoring cold water.
- Producing substantial volumes of pale urine.
- Frequent nocturnal urination and water consumption.
On average, adults typically expel 1 to 3 quarts (approximately 1 to 3 liters) of urine per day. However, individuals with diabetes insipidus who consume large quantities of fluids might generate as much as 20 quarts (about 19 liters) of urine daily.
Child Symptoms include:
- Large amounts of pale urine lead to saturated diapers.
- Bed-wetting.
- Excessive thirst, especially for water and cold beverages.
- Weight loss.
- Poor growth.
- Vomiting.
- Irritability.
- Fever.
- Constipation.
- Headache.
- Sleep disturbances.
- Vision issues.
When to see a doctor
See your healthcare provider right away if you notice that you’re urinating much more than usual and you’re very thirsty on a regular basis.
Causes:
female urinary system
Diabetes insipidus occurs when the body cannot maintain a healthy balance of fluid levels.
The blood’s fluid passes through the kidneys for waste removal. Subsequently, most of this fluid returns to the bloodstream. Waste, along with a small amount of fluid, exits the kidneys as urine. The bladder temporarily stores urine before it leaves the body.
An essential hormone, known as antidiuretic hormone (ADH) or vasopressin, is required to reabsorb the filtered fluid from the kidneys into the bloodstream. The hypothalamus, situated in the brain, produces ADH, which is then stored in the pituitary gland at the base of the brain. Conditions that reduce ADH production or hinder its effectiveness result in excessive urine production.
In diabetes insipidus, the body struggles to regulate fluid levels appropriately. The underlying cause of fluid imbalance depends on the type of diabetes insipidus.
- Central diabetes insipidus: Damage to the pituitary gland or hypothalamus due to surgery, tumors, head injuries, or illnesses can lead to central diabetes insipidus. This damage affects the production, storage, and release of ADH. In some cases, it may be caused by an inherited disorder or an autoimmune reaction that damages the ADH-producing cells.
- Nephrogenic diabetes insipidus: This type occurs when the kidneys are unable to respond properly to ADH. The causes may include inherited disorders, certain medications (like lithium and antiviral drugs such as foscarnet), low blood potassium levels, high blood calcium levels, urinary tract blockage or infection, or chronic kidney conditions.
- Gestational diabetes insipidus: This rare form emerges exclusively during pregnancy. It results from an enzyme produced by the placenta that breaks down ADH in pregnant individuals.
- Primary polydipsia (dipsogenic diabetes insipidus): People with this disorder experience constant thirst and consume excessive fluids. It can stem from damage to the thirst-regulating mechanism in the hypothalamus and has also been associated with mental illnesses such as schizophrenia.
In some cases, the cause of diabetes insipidus remains unclear. In that case, repeated testing over time may help uncover an underlying cause eventually.
Risk Factors
Diabetes insipidus can affect anyone, but individuals with the following characteristics are at an elevated risk:
- A family history of the condition.
- Use certain medications, including diuretics, which may contribute to kidney issues.
- Elevated levels of calcium or diminished potassium levels in their bloodstream.
- A history of significant head trauma or brain surgery.
Complications
Dehydration:
Diabetes insipidus can result in dehydration, characterized by excessive fluid loss from the body. Dehydration may give rise to the following symptoms:
- Dry mouth.
- Intense thirst.
- Profound fatigue.
- Dizziness.
- Lightheadedness.
- Fainting.
- Nausea.
Electrolyte Imbalance
Diabetes insipidus has the potential to alter the concentrations of minerals in the bloodstream responsible for regulating the body’s fluid equilibrium. These minerals, known as electrolytes, encompass sodium and potassium. Signs of an electrolyte imbalance can encompass:
- Weakness.
- Nausea.
- Vomiting.
- Decreased appetite.
- Confusion.
Diabetes Isipidus Treatment
Initially, your doctor will advise you to maintain a high fluid intake to compensate for the continuous loss of water. Further treatment strategies depend on the type of diabetes insipidus you have:
- Central diabetes insipidus: In this case, you’ll be prescribed medications like desmopressin (DDAVP). Desmopressin helps regulate urine output, uphold fluid balance, and prevent dehydration. It’s typically taken two or three times a day and is available in nasal spray, tablet, or injection forms. Additionally, there are complementary treatments to enhance the effectiveness of these medications.
- Nephrogenic diabetes insipidus: This type can be more challenging to treat. If it’s triggered by a medication, discontinuing the drug is the first step. Other medications may alleviate symptoms, including indomethacin (Indocin) and diuretics like amiloride (Moduretic 5-50) or hydrochlorothiazide (Microzide). Although diuretics typically increase urine output, in this instance, they help reduce it. Sometimes, treating the underlying cause can lead to the resolution of this condition.
- Gestational diabetes insipidus: During pregnancy, you can use desmopressin as a treatment. Typically, your symptoms should subside after giving birth.
Also read: What are the early signs of Diabetes?
Final Thought:
Different things can cause diabetes insipidus, like low potassium, high calcium, or problems in the kidneys. Going for a monthly checkup is important to save yourself and your child from this rare but harmful disease. Always follow the doctor’s advice if any family member gets diagnosed with it, and recommend this to others who are suffering from the same disease.
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