Diabetes Insipidus

What is diabetes insipidus?

Diabetes insipidus is a disorder in which the body produces too much urine and is not able to retain water.

People with this condition pass urine frequently and drink large amounts of water. They tend to feel thirsty all the time since their body finds it difficult to retain water.

Diabetes insipidus can be a chronic condition or a temporary one. It may be mild or severe, depending on what is causing it. It is usually caused by an issue with the antidiuretic hormone (ADH).

What are the symptoms of diabetes insipidus?

Symptoms of diabetes insipidus may be mild or severe, depending on your specific condition. The main symptoms are as follows:

• Frequent passing of urine during the day and at night
• Passing large volume of light-colored urine
• Feeling thirsty all the time (polydipsia) and drinking lots of water or liquids 
• Dry skin

Other diabetes insipidus symptoms you may experience include:

• Feeling dizzy
• Feeling lethargic
• Dehydration 
• Bed-wetting due to a large volume of urine 

What are the causes of diabetes insipidus?

Diabetes insipidus is caused by issues with your body’s ability to retain water and regulate fluid levels. Your kidneys filter out excess water and fluid from your body and remove waste products.

This condition is usually caused by problems with the ADH hormone (also called vasopressin), which helps your kidneys balance the fluid levels in your body. It can also be caused by issues with the part of your brain that stimulates thirst. The diabetes insipidus causes differ based on different types. 

Sometimes, there is no certain cause of diabetes insipidus. In certain rare cases, the disorder may be caused by an autoimmune condition or response that makes the immune system attack the cells that make vasopressin.

What are the types of diabetes insipidus?

There are 4 different types of diabetes insipidus. They are as follows:

1. Central diabetes insipidus 

This is caused by damage to the brain, which affects the release and regulation of ADH in the body. 

2. Nephrogenic diabetes insipidus

This is caused by a structural defect in the kidneys that affects their response to ADH.

3. Gestational diabetes insipidus

This type of diabetes insipidus is rare and occurs during pregnancy. It is caused when an enzyme released by the placenta starts to destroy ADH in the mother. 

4. Dipsogenic diabetes insipidus

This is caused by damage to the part of the hypothalamus (in the brain) that regulates thirst. 

What are the complications of diabetes insipidus?

If left untreated, diabetes insipidus can lead to more serious complications. These include:

• Severe dehydration 
• Seizures 
• Brain damage 
• Mineral and fluid imbalance leading to fatigue and nausea

How is diabetes insipidus diagnosed?

Diabetes insipidus is diagnosed through different tests and methods.

The main tests for diabetes insipidus diagnosis include the following: 

1. Water deprivation test

You will be asked not to drink any fluids for several hours. This stimulates your body to produce ADH. The doctor will then measure your ADH levels to determine if your body is producing enough ADH. The doctor may also measure other factors such as urine output.

2. Blood and urine test

Your doctor may suggest a blood test to check your ADH levels. Your blood and urine may also be tested for glucose (blood sugar), calcium, and potassium.

3. Magnetic resonance imaging (MRI) 

An MRI scan is used to check for abnormalities in the pituitary gland and hypothalamus in the brain.

4. Genetic screening

If factors in your family suggest a genetic cause, your doctor may recommend genetic screening. 

How is diabetes insipidus treated? 

Diabetes insipidus treatment differs based on the type. The treatments are as follows:

Treatment for central diabetes insipidus 

If you have mild diabetes insipidus, increasing your water intake may be sufficient, and medication may not be required.

If the condition is caused by an abnormality in the pituitary gland or hypothalamus, your doctor will treat the lack of ADH. It is usually treated with desmopressin, a hormone that works similarly to ADH. It is taken as an injection, a pill, or a nasal spray. 

Treatment for nephrogenic diabetes insipidus

It is usually treated with diuretics, which reduce the urine produced by your kidneys. It may also be supplemented with medication to reduce your urine volume. 

Treatment for dipsogenic diabetes insipidus

There is no specific treatment for dipsogenic diabetes insipidus. However, if it is caused by an underlying issue such as a brain-related condition, treatment can target the cause. 

Treatment for gestational diabetes insipidus

Treatment for people with gestational diabetes insipidus is often administered in the form of the hormone desmopressin.

Risk factors for developing diabetes insipidus

Certain factors can contribute to your risk of developing diabetes insipidus. These factors are as follows:

• If you have a family history of diabetes insipidus.
• If you have undergone brain surgery or suffered a serious head injury.
• If you are taking medications that can lead to kidney problems as side effects.
• If you suffer from metabolic disorders that affect your mineral levels, such as calcium and potassium levels.
• If you are pregnant, risk factors include liver conditions as well as being pregnant with more than one child.

Conclusion

Diabetes insipidus can be uncomfortable and difficult to live with. If the condition is not addressed, it may lead to severe dehydration and other complications.

If you are facing any symptoms such as excessive thirst and frequent passing of urine, it is best to get it checked by a medical specialist. 

To avail of the best diagnosis and treatment for diabetes insipidus, visit the CK Birla Hospital or book an appointment with Dr. Abhay Ahluwalia

FAQs

1. What are the 4 types of diabetes insipidus?

The 4 types of diabetes insipidus are as follows: 

1) Central diabetes insipidus (problems with ADH in the body)

2) Nephrogenic diabetes insipidus (structural defect in the kidneys)

3) Gestational diabetes insipidus (occurs during pregnancy)

4) Dipsogenic diabetes insipidus (problem with thirst function)

2. What is the difference between diabetes insipidus and diabetes?

Diabetes insipidus and diabetes (diabetes mellitus or Type 1 or Type 2 diabetes) are two distinct conditions.

Diabetes mellitus happens because your body is not producing enough insulin or is not able to use it well. Diabetes insipidus occurs because your body is not producing enough antidiuretic hormone (ADH) or your kidneys are not able to use it properly. 

3. At what age is diabetes insipidus usually diagnosed?

You can be diagnosed with diabetes insipidus at any point in your life.

Central diabetes insipidus can often be diagnosed in infants as it is related to a brain condition that is present, affecting the hypothalamus and pituitary gland.

Nephrogenic diabetes insipidus may also be diagnosed in infancy or early in life as it is often caused by a genetic condition.

Gestational diabetes insipidus is diagnosed when you are pregnant. 

4. Is diabetes insipidus a lifelong disease?

Diabetes insipidus may be a chronic condition or a temporary one. It can be treated if it is caused by a treatable underlying condition.

However, if it is not a treatable condition (which is often the case with dipsogenic diabetes insipidus), then it may be a chronic condition.