Diabetes Insipidus

What is Diabetes Insipidus? What are its causes, symptoms, prevention and treatment for diabetes insipidus?

Diabetes Insipidus is a rare disease caused by the failure of the kidneys to conserve water and stops filtering urine. Diabetes insipidus is not same as diabetes mellitus. This disease leads to excessive urination and thirst which is one common symptom between diabetes mellitus and insipidus. The fluid retention is managed by anti-diuretic hormone which is produced in the brain by hypothalamus as well as controlled by pituitary gland located at the bottom of the brain.

The extra fluid is removed through kidneys from bloodstream. This fluid is stored as urine in bladder. If the fluid regulation system is working properly, the kidneys make less urine when body is loosing water or at night when the metabolic rates are slow.

SYMPTOMS OF DIABETES INSIPIDUS
- Frequent urination.
- Colorless urine.
- Bed-wetting.
- Disruption is sleep.
- Dry skin and weakness.
- Fever.
- Vomiting.
- Diarrhea.

TYPES OF DIABETES INSIPIDUS
- Central Diabetes Insipidus : Head injury, infection, surgery and tumor can cause damage to the hypothalamus or pituitary gland that can cause central diabetes insipidus. It disrupts the storage and release of ADH.
- Nephrogenic Diabetes Insipidus : Kidneys do not respond to ADH. It can be caused due to some chronic disorders or some drugs.
- Dipsogenic Diabetes Insipidus : It is a rare form of diabetes insipidus and is caused when there is a defect or problem in the thirst mechanism. The thirst increases abnormally resulting in more urine output.
- Gestational Diabetes Insipidus : It occurs during pregnancy. It occurs when and enzyme made by the placenta destroys ADH in the mother.

DIAGNOSIS OF DIABETES INSIPIDUS
There is a possibility that diabetes mellitus can cause diabetes insipidus. Diagnosis includes:
- Physical examinations.
- Blood tests.
- Urinalysis is the physical and chemical examination of urine.
- Fluid deprivation test helps in determining whether diabetes insipidus is caused by excessive intake of fluid, defect in ADH production or defect in kidney’s response to ADH.

Complications may include dehydration, weakness, fatigue, low body temperature, kidney and brain damage, headaches.

Prevention includes drinking plenty of fluids, following a low salt diet, few medications may help. Treatment includes:
- Vasopressin can be taken to cure central diabetes insipidus.
- Stopping the medication can treat nephrogenic diabetes insipidus.
- Hereditary nephrogenic diabetes insipidus is treated with fluid intake to match urine output and drugs that lower urine output.

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What is Diabetes Insipidus ?

Diabetes Insipidus is a rare disorder, resulting in excessive thirst and excessive passage of very dilute urine, due to a hormone deficiency in the pituitary gland, which is situated at the base of the brain.
Diabetes Insipidus results from a decreased production of antidiuretic hormone (vasopressin), the hormone that normally prevents the kidney from producing too much urine. Children with DI may be irritable or listless and may have fever, vomiting, or diarrhea. Milder forms of DI can be managed by drinking enough water, usually between 2 and 2.5 liters a day. DI severe enough to endanger a person’s health is rare.

Signs & Symptoms :
- Excessive thirst that is difficult to satisfy.
- Passage of large amounts (up to 15 quarts a day) of diluted, colorless urine.
- Dehydration, leading to rapid heart rate, low blood pressure and shock.
- Constipation.
- Mild cases may present with unremitting enuresis (bed-wetting).

Risk Factors :
- Brain tumor or pituitary gland tumor.
- Head Injury
- Infections such as meningitis, encephalitis, tuberculosis.
- Sarcoidosis
- Family history of diabetes insipidus.
- Atherosclerosis (hardening of the arteries).

Diabetes Insipidus is not the same as diabetes mellitus (“sugar” diabetes). Diabetes Insipidus resembles diabetes mellitus because the symptoms of both diseases are increased urination and thirst. However, in every other respect, including the causes and treatment of the disorders, the diseases are completely unrelated.

There are four (4) fundamentally different types of Diabetes Insipidus(DI). Each has a different cause and must be treated in a different way. These four forms are:
- Neurogenic, also known as central, hypothalamic, pituitary or neurohypophyseal, is caused by a deficiency of the antidiuretic hormone, vasopressin.
- Nephrogenic, also known as vasopressin-resistant is caused by insensitivity of the kidneys to the effect of the antidiuretic hormone, vasopressin.
- Gestagenic, also known as gestational is also caused by a deficiency of the antidiuretic hormone, vasopressin, that occurs only during pregnancy.
- Dipsogenic, a form of primary polydipsia is caused by abnormal thirst and the excessive intake of water or other liquids.

How do you test for diabetes insipidus?
Usually your doctor will check your urine to see how much water is in it. He or she may also check your blood. Your doctor may give you a “water deprivation” test. During this test, you aren’t allowed to drink any liquids. The staff will weigh you, check your urine and blood every hour for several hours. If the results of the test show that you have diabetes insipidus, you will probably also have pictures taken of your brain with a CT (computed tomographic) scan or an MRI (magnetic resonance image).

Medications:
- Vasopressin or desmopressin acetate, modified synthetic forms of antidiuretic hormone, may be taken as a nasal spray several times a day, to maintain a normal urine output. However, taking too much of this medication can cause fluid retention and swelling and other problems.
- Sometimes diabetes insipidus can be controlled with drugs that stimulate production of antidiuretic hormone such as chlorpropamide, carbamazepine, clofibrate.

Diet: No special diet. Drink as much water as you feel you need.

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The Official Patient’s Sourcebook on Diabetes Insipidus: Directory for the Internet Age (Paperback)