Description

Diabetes insipidus (die-uh-BEE-teze in-SIP-uh-dus) is a common problem that causes the fluids in the body to become out of balance. That prompts the body to make large amounts of urine. It also causes a feeling of being very thirsty, even after having something to drink. Diabetes insipidus is also called arginine vasopressin deficiency of arginine vasopressin resistance.

While the terms "diabetes insipidus" and "diabetes mellitus" sound the same, the two conditions that are not connected. Diabetes mellitus leads to high levels of sugar in the blood. It is a common condition, and is often simply called diabetes.

There is No cure for diabetes insipidus. But you have a treatment that can relieve your symptoms. That includes the relief of thirst, the reduction of the amount of urine produced by the body and the prevention of dehydration.

Symptoms

The symptoms of diabetes insipidus in adults include:

  • Being very thirsty, often with a preference for the cold water.
  • The realization of large amounts of urine pale.
  • Get up to urinate and drink water frequently during the night.

Adults tend to urinate an average of 1 to 3 quarts (about 1 to 3 liters) per day. People who have diabetes insipidus and drink plenty of fluids can make as much as 20 quarts (about 19 liters of urine per day.

A baby or a child who has diabetes insipidus may have these symptoms:

  • Large amounts of urine pale in the result of heavy, wet diapers.
  • Bed-wetting.
  • Being very thirsty, with a preference for drinking water and cold liquids.
  • The loss of weight.
  • Poor growth.
  • Vomiting.
  • Irritability.
  • Fever.
  • The constipation.
  • The pain of a headache.
  • Sleep problems.
  • Vision problems.

When to see a doctor

Consult your health care provider right away if you notice that you are urinating more than usual and have a lot of thirst, on a regular basis.

Causes

Diabetes insipidus occurs when the body can't balance your fluid levels in a healthy way.

Fluid in the blood is filtered through the kidneys to remove waste. Later, most of the liquid is returned to the bloodstream. The waste and a small amount of fluid from the kidneys in the form of urine. The urine leaves the body after it is temporarily stored in the bladder.

A hormone known as antidiuretic hormone (ADH), also called vasopressin — it is necessary to obtain the fluid that is filtered out by the kidneys back into the bloodstream. ADH is made in a part of the brain called the hypothalamus. It is then stored in the pituitary gland, a gland found in the base of the brain. The conditions that cause the brain to the ADH or disorders that block the effect of ADH causes the body to produce too much urine.

In diabetes insipidus, the body is not able to balance the fluid levels. The cause of the imbalance of water depends on the type of diabetes insipidus.

  • Central Diabetes insipidus. Damage to the pituitary gland or the hypothalamus of the surgery, a tumor, a head injury or a disease that can cause central diabetes insipidus. The damage affects the production, storage and release of ADH . A hereditary disorder that can cause this condition as well. It can also be the result of an autoimmune reaction that causes the body's immune system to damage the cells that cause ADH .
  • Nephrogenic diabetes insipidus. This happens when there is a problem with the kidneys, which makes them unable to adequately respond to the ADH . That problem may be due to: An inherited disorder.Certain medications, such as lithium and the antiviral drugs such as foscarnet (Foscavir).Low levels of potassium in the blood.High levels of calcium in the blood.A urinary tract obstruction or infection of the urinary tract.A chronic disease of kidney.
  • An inherited disorder.
  • Certain medications, such as lithium and the antiviral drugs such as foscarnet (Foscavir).
  • Low levels of potassium in the blood.
  • High levels of calcium in the blood.
  • A urinary tract obstruction or infection of the urinary tract.
  • A chronic disease of kidney.
  • Gestational diabetes insipidus. This rare form of diabetes insipidus occurs only during pregnancy. It develops when an enzyme produced by the placenta destroys ADH in a pregnant person.
  • Polydipsia primary. This condition is also called dipsogenic diabetes insipidus. People who have this disorder and the constant feeling of thirst and drinking plenty of fluids. It can be caused by damage to the thirst-regulating mechanism in the hypothalamus. It has also been linked to mental illness, such as schizophrenia.
  • An inherited disorder.
  • Certain medications, such as lithium and the antiviral drugs such as foscarnet (Foscavir).
  • Low levels of potassium in the blood.
  • High levels of calcium in the blood.
  • A urinary tract obstruction or infection of the urinary tract.
  • A chronic disease of kidney.

Sometimes there is not a clear cause of diabetes insipidus can be found. In that case, repeat the test with the time, is often useful. The tests may be able to identify an underlying cause with the time.

Risk factors

Anyone can get diabetes insipidus. But those who are most at risk are people who:

  • Having a family history of the disease.
  • Taking certain medications, such as diuretics, which may lead to kidney problems.
  • Have high levels of calcium or low potassium levels in your blood.
  • Has had a severe head injury or brain surgery.

Complications

Dehydration

Central Diabetes insipidus can lead to dehydration. That occurs when the body loses too much fluid. Dehydration can cause:

  • Dry mouth.
  • Of thirst.
  • Extreme tiredness.
  • The dizziness.
  • The dizziness.
  • Fainting.
  • Nausea.

Electrolyte imbalance

Diabetes insipidus can change the levels of minerals in the blood that maintain the body's fluid balance. The minerals called electrolytes, including sodium and potassium. The symptoms of an electrolyte imbalance may include:

  • The weakness.
  • Nausea.
  • Vomiting.
  • Loss of appetite.
  • Confusion.

Diagnosis

The tests used for the diagnosis of diabetes insipidus include:

  • Water deprivation test.For this test, you stop drinking fluids for several hours. During the test, the doctor measures the changes in body weight, the amount of urine produced by the body, and the concentration of the urine and the blood. Your health care provider also may measure the amount ofADHin his blood. During this test, you can receive a manufactured form ofADH. They can help show if your body is making enoughADHand if your kidneys can respond as expected toADH.
  • Urine test. Test your urine to see if it contains too much water can be useful in the identification of diabetes insipidus.
  • Blood tests. Check the levels of certain substances in the blood, such as sodium, potassium, and calcium, may help with the diagnosis and may be useful in the identification of the type of diabetes insipidus.
  • Magnetic resonance imaging (MRI). An mri scan may detect problems with the pituitary gland or the hypothalamus. This imaging test uses a powerful magnetic field and radio waves to create detailed images of the brain.
  • The genetic testing. If other people in your family has had problems with excessive urination, or have been diagnosed with diabetes insipidus, your doctor may suggest genetic testing.

Water deprivation test. For this test, you stop drinking fluids for several hours. During the test, the doctor measures the changes in body weight, the amount of urine produced by the body, and the concentration of the urine and the blood. Your health care provider also may measure the amount of ADH in the blood.

During this test, you can receive a manufactured form of ADH . They can help show if your body is making enough ADH and if your kidneys can respond as expected to the ADH .

Treatment

If you have mild diabetes insipidus, you may only need to drink more water to avoid dehydration. In other cases, the treatment is usually based on the type of diabetes insipidus.

  • Central Diabetes insipidus.If the central diabetes insipidus is caused by a disorder in the pituitary gland or the hypothalamus, such as a tumor, that disease is treated in the first place. When treatment is necessary beyond that, a manufactured hormone called desmopressin (DDAVP, Nocdurna) is used. This medicine replaces the lack of the antidiuretic hormone (ADH) and decreases the amount of urine the body makes. Desmopressin is available in pill form, as a nasal spray and as a shot. If you have central diabetes insipidus, it is likely that your body still makes someADH. But the amount it may change from day to day. This means that the amounts of desmopressin that you need, you can also change. Take more of desmopressin that you need can cause water retention. In some cases, it can cause potentially severe, low levels of sodium in the blood. Talk with your health care provider about how and when to adjust the dose of desmopressin.
  • Nephrogenic diabetes insipidus.Because the kidneys do not respond properly toADHin this form of diabetes insipidus, desmopressin is not helpful. Instead, your health care provider may recommend that you eat a diet low in salt to reduce the amount of urine from the kidneys to do. Treatment with hydrochlorothiazide (Microzide) may help relieve your symptoms. Although hydrochlorothiazide is a diuretic — a medication that causes the body to produce more urine can decrease the production of urine for some people with diabetes insipidus. If your symptoms are due to the drugs you are taking, stop the medication can help. But do not stop taking any medication without first talking to your health care provider.
  • Gestational diabetes insipidus. The treatment for gestational diabetes insipidus involves the taking of the plant hormone desmopressin.
  • Polydipsia primary. There is No specific treatment for this form of diabetes insipidus apart from the reduction of the amount of fluids you drink. If the condition is related to a mental illness, the treatment can alleviate the symptoms.

Central Diabetes insipidus. If the central diabetes insipidus is caused by a disorder in the pituitary gland or the hypothalamus, such as a tumor, that disease is treated in the first place.

When treatment is necessary beyond that, a manufactured hormone called desmopressin (DDAVP, Nocdurna) is used. This medicine replaces the lack of the antidiuretic hormone (ADH) and decreases the amount of urine the body makes. Desmopressin is available in pill form, as a nasal spray and as a shot.

If you have central diabetes insipidus, it is likely that your body still makes some ADH . But the amount it may change from day to day. This means that the amounts of desmopressin that you need, you can also change. Take more of desmopressin that you need can cause water retention. In some cases, it can cause potentially severe, low levels of sodium in the blood. Talk with your health care provider about how and when to adjust the dose of desmopressin.

Nephrogenic diabetes insipidus. Because the kidneys do not properly respond to the ADH in this form of diabetes insipidus, desmopressin is not helpful. Instead, your health care provider may recommend that you eat a diet low in salt to reduce the amount of urine from the kidneys to do.

Treatment with hydrochlorothiazide (Microzide) may help relieve your symptoms. Although hydrochlorothiazide is a diuretic — a medication that causes the body to produce more urine can decrease the production of urine for some people with diabetes insipidus.

If your symptoms are due to the drugs you are taking, stop the medication can help. But do not stop taking any medication without first talking to your health care provider.

Lifestyle and home remedies

If you have diabetes insipidus:

  • Prevent dehydration. How to take your medicine and have easy access to the water, the more likely it is to be able to prevent serious problems of dehydration. Plan ahead and take water with you wherever you go. Keep a supply of medicines with you when you are away from home.
  • Wear a medical alert bracelet or carry a card of a medical alert. If you have a medical emergency, the alert provides information that their health care providers need to give it the proper care.

Preparing for your appointment

It is likely that you first consult your primary care provider. But when you call to schedule an appointment, you may be referred to a specialist called an endocrinologist — a doctor who focuses on disorders of the hormone.

Here's some information to help you prepare for your appointment.

What you can do

  • Ask about restrictions to follow prior to your appointment. At the time of making the appointment, ask if there is something that you need to do beforehand. Your doctor may ask you to stop to drink water the night before the appointment. But do this only if your health care provider asks you to.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. Be prepared to answer questions about the frequency of urination and the quantity of water you drink each day.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of your key medical information, including any recent surgeries, the names of all the medications you are taking and the dose, and any other conditions for which it has been recently treated. Your health care provider is also likely to ask about any recent injury to the head.
  • Have a family member or friend along, if possible. Sometimes it can be difficult to remember all information that is obtained during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Write questions to ask their health care provider.

For diabetes insipidus, some basic questions to ask your health care provider include:

  • What is the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • Is my condition likely temporary or will I forever?
  • What treatments are available, and which do you recommend for me?
  • How will you control if the treatment is working?
  • I need to make changes in my diet or lifestyle?
  • Do you still need to drink a lot of water, if I am taking medications?
  • I have other health conditions. How can I best manage these conditions?
  • Are there restrictions in the diet should I follow?
  • Are there brochures or other printed material that I can take home, or web sites that you recommend?

What to expect from your doctor

Your health care provider is likely to ask questions such as:

  • When did the symptoms begin?
  • How much more is urinating than usual?
  • What amount of water you drink each day?
  • Do you wake up in the night to urinate and drink the water?
  • Are you pregnant?
  • Are being treated or have recently been treated for other medical conditions?
  • Have you recently suffered injuries in the head, or has had the neurosurgery?
  • Has someone in your family has been diagnosed with diabetes insipidus?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?

What you can do in the meantime

While you're waiting for your appointment, drink until your thirst is relieved, as often as necessary. Avoid activities that can cause dehydration, such as exercise, other physical effort, or spend time in the heat.

Symptoms and treatment of Diabetes insipidus