Overview
Diabetes insipidus (DI) is a rare condition involving fluid imbalance. The resulting chemical imbalance causes you to urinate excessively. Consequently, you’ll be constantly thirsty even if you drink plenty of water.
Diabetes insipidus and diabetes mellitus may sound similar, but they are different. Type 1 and type 2 diabetes mellitus, characterized by elevated blood sugar levels, are extremely prevalent and sometimes referred to as diabetes.
Key Facts
- Extreme urination is a symptom of diabetes insipidus, a condition that affects a small percentage of the population.
- Diabetes insipidus is currently incurable. However, treatments available can decrease your urine production, reduce your thirst, and prevent you from getting dehydrated.
- Constant urge to urinate and drink water is common in diabetes insipidus and diabetes mellitus.
- Diabetes insipidus is caused by the malfunction of the hormones that regulate fluid balance in the body.
- The disease affects only 1 in every 25,000 people.
- An increased risk of developing diabetes insipidus may result from inherited changes in genetic makeup.
Types of Diabetes Insipidus
According to the National Institute of Diabetes and Digestive and Kidney Diseases, the types of diabetes Insipidus are:
- Central Diabetes Insipidus
In this disease, injuries to the hypothalamus or pituitary gland disrupt the production or secretion of a water-regulating hormone called vasopressin or antidiuretic hormone (ADH). If you notice a rise in your urination frequency, it may be because your kidneys are shedding excess fluid.
- Nephrogenic Diabetes Insipidus
This condition develops when the kidneys fail to react to vasopressin and remove too much fluid from circulation.
- Gestational Diabetes Insipidus
This type of diabetes insipidus is particularly rare and only occurs in pregnancy, hence its name.
The placenta, the maternal organ that supplies oxygen and nutrition to the developing infant, can produce an enzyme that destroys vasopressin. Similarly, some pregnant women’s kidneys are more resistant to vasopressin because they produce more prostaglandin, a hormone-like substance.
Most women with gestational diabetes insipidus have mild or silent symptoms. Normal functioning is restored after giving birth, although the problem can recur during subsequent pregnancies.
- Dipsogenic Diabetic Insipidus
The hypothalamus’s failure to properly regulate thirst is the cause of dipsogenic diabetes insipidus. If you suffer from this disorder, you may have an uncontrollable thirst and consume excessive fluid. Medications and health issues, especially mental health issues, have been linked to developing dipsogenic diabetes insipidus.
Symptoms
People with diabetes insipidus may experience the following symptoms:
- Severe thirst
- Polyuria: Excessive production of urine, over three liters daily.
- Frequent urge to get up in the middle of the night
- Nocturnal enuresis: Urinating during sleep (bed-wetting)
- Clear, colorless urination
- Low urine concentration
- Preference for cold beverages
- Extreme dehydration, which can lead to fatigue, lethargy, dizziness, confusion, nausea, and loss of consciousness.
- Weakness
- Sore muscles
- Irritability
- Weight loss
- Constipation
- Vomiting
- Fever
- Retarded growth
Diagnosis
The following procedures are used to test for diabetes insipidus:
- Water Deprivation Test
ADH enables your kidneys to reduce the quantity of fluid lost through urine production. This helps prevent dehydration when fluid intake is restricted. During this test, you will be urged to refrain from drinking fluids for several hours while a physician and a healthcare team observe you.
While you are dehydrated, your doctor will monitor your weight, urine volume, and blood and urine concentrations for any changes. The physician may also check your ADH blood levels during this evaluation or administer synthetic ADH. This will determine if your kidneys can normally respond to ADH and whether your body is producing (or secreting) enough ADH or not.
- Magnetic Resonance Imaging
The pituitary gland and its surrounding tissues can be scanned using MRI for any abnormalities or damages. Brain tissue images are constructed using strong magnetic fields and radio waves during this procedure. This examination causes no harm to the patient.
- Genetic Screening
Your doctor may recommend genetic testing if you have a family history of urinary incontinence.
- Urinalysis
This procedure examines your urine concentration for signs of diabetes insipidus.
Causes
In most cases, diabetes insipidus occurs due to difficulties with how the body produces or uses antidiuretic hormone (also known as vasopressin). In normal conditions, the hormone enables your kidneys to maintain a healthy fluid balance throughout your body.
Central diabetes insipidus could result from:
- Unhealthy growth of tissue (tumor)
- Injuries to the head
- A bloated or clogged artery (aneurysm)
- Diseases such as Langerhans cell histiocytosis
- Infection
- Inflammation
- Surgery
Sometimes, doctors can’t pinpoint a specific cause of nephrogenic diabetes insipidus.
However, they’ve identified some of the following causes:
- Obstruction of the urinary tract
- Inflammation of the kidneys
- High blood calcium levels
- Chronically low blood potassium levels
- Drugs containing lithium
Prevention
You can reduce your chances of contracting diabetes insipidus by:
- Decreasing salt intake
- Avoiding lithium and other medications known to affect the kidneys negatively.
- Maintaining adequate water intake
Typical Treatments
Diabetes insipidus is usually a lifelong condition and currently has no cure. However, the condition can be effectively managed through adequate measures.
The treatment options for diabetes insipidus (DI) are condition-specific. When a decrease in vasopressin production is responsible for DI, vasopressin replacement therapy is necessary.
In most cases, the patient sniffs a tiny amount of vasopressin that the lining of the nose can absorb. It is critical to replenish lost fluids in cases of DI where the response to vasopressin is diminished or nonexistent.
Other treatment and management procedures for diabetes insipidus include:
- Adequate fluid consumption
- Reduction of daily dietary salt intake
- Hydrochlorothiazide and non-steroidal anti-inflammatory medications.
Furthermore, certain forms of diabetes Insipidus, such as those that develop after a head injury, neurosurgery, or pregnancy, improve over time.
Conclusion
There is no risk of kidney failure or need for dialysis treatment for people with diabetes insipidus. The patient’s kidneys will continue to perform their primary function: filter blood.
However, the condition increases one’s risk of dehydration. So, staying hydrated when working out or during hot weather is crucial.
Individuals with diabetes insipidus should always take their medication and stay out of places where drinking water can’t be easily accessed.
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