Diabetes insipidus is a rare condition that affects the way your body handles fluids. When you have diabetes insipidus your kidneys can’t conserve water as they normally do so you end up urinating a lot and becoming very thirsty and, in some cases, it can also cause dehydration and weight loss. If left untreated, diabetes insipidus can lead to serious health complications. There is no one-size-fits-all treatment for diabetes insipidus because treatment options may vary depending on the underlying cause. In this article, we will discuss everything you need to know about diabetes insipidus, its symptoms, causes, treatment options, and more.
What is diabetes insipidus?
Diabetes insipidus, also called DI for short, is a condition where your body doesn’t make enough of the hormone vasopressin, which is also called antidiuretic hormone (ADH). Vasopressin helps your body regulate the amount of water in your blood. Your brain produces vasopressin in the hypothalamus and stores it in your pituitary gland until your body needs it due to low water levels. Vasopressin signals your body to retain more water by telling your kidneys to release less of it in urine, which makes you have more concentrated urine. When your body doesn’t have the signal to retain more water, your diluted urine may have too much of it that your body needs and it can lead to dehydration. Please note that despite having similar names diabetes mellitus and diabetes insipidus are not related.
Central diabetes insipidus (CDI)
Central diabetes insipidus is the most common form of diabetes insipidus. It occurs when there’s damage to your hypothalamus or pituitary gland, or due to genetics which prevents vasopressin from being released.
Nephrogenic diabetes insipidus (NDI)
Nephrogenic diabetes insipidus is caused by a defect in your kidneys that prevents your kidneys from responding to vasopressin. Nephrogenic diabetes insipidus is either inherited or caused by a chronic condition. Certain drugs, especially lithium, can also cause it.
Dipsogenic diabetes insipidus
Dipsogenic diabetes insipidus is also called chronic polydipsia and is caused by an increase in thirst or fluid intake due to damage to your hypothalamic thirst mechanism which tells you when you are thirsty. It can also be the result of psychological disorders or damage to the hypothalamus.
Gestational diabetes insipidus
Gestational diabetes insipidus is a temporary form of diabetes insipidus that can occur during pregnancy due to the decreased levels of vasopressin in your blood. The decreased levels of vasopressin are affected by an enzyme produced by your placenta eliminating vasopressin and it usually goes away after delivery.
What are the symptoms of diabetes insipidus?
The most common symptom of diabetes insipidus is increased urination, also called polyuria, due to excessive urine production. You may urinate more than 20 times a day and have very large amounts of pale, diluted urine. Other common symptoms for adults include:
- Excessive thirst, also called polydipsia
- Dry mouth
- Having to urinate throughout the night
- Preference for cold drinks
Unfortunately, babies and young children can also get diabetes insipidus. When your child has it, their symptoms may include:
- Heavy, soaked diapers
- Wetting the bed even when they are potty trained
- Trouble sleeping
- Weight loss
- Stunted growth
If you or your child are experiencing these symptoms, please talk to your doctor or medical professional.
What are the risk factors of diabetes insipidus?
There are only two risk factors and they are both for nephrogenic diabetes. The first risk factor is an inherited gene that causes nephrogenic diabetes to be present at birth or soon after it. The second risk factor of nephrogenic diabetes is being male, although women can be carriers of the gene and pass it on to their children.
What are the complications of diabetes insipidus?
If diabetes insipidus is not treated, it can lead to dehydration and a lack of electrolytes in your body. When you have dehydration you can exhibit the following common symptoms:
- Dry mouth
- Different skin elasticity
Electrolytes are minerals that help with the electrical impulses in your body and muscles and include sodium, potassium, chloride, and bicarbonate. When these levels get too low it can cause:
- Muscle cramps
- Loss of appetite
If you or your child are experiencing any of these symptoms, please seek medical attention immediately. If diabetes insipidus is left untreated, it can be fatal.
How do doctors diagnose diabetes insipidus?
If you or your child are experiencing the symptoms of diabetes insipidus, the first step is to see your doctor. Your doctor will ask about your medical history and perform a physical exam. Your doctor may also order one or more of the following tests for diagnosis of diabetes insipidus:
Water deprivation test
A water deprivation test is the most definitive way to diagnose diabetes insipidus. It involves limiting your fluid intake and monitoring your body weight, urine output, the concentration of your urine, and blood chemistry for changes. The test may last for several hours and you will be closely monitored by a medical team.
Magnetic resonance imaging (MRI)
An MRI uses powerful magnets and radio waves to create images of your brain. It can be used to look for damage to the pituitary gland or hypothalamus, which can cause diabetes insipidus.
Since genetics can be a factor for diabetes insipidus, genetic screening may be used by your doctor to see if this is the cause.
How is diabetes insipidus treated?
The treatments vary for the four types of diabetes insipidus as they all have different causes. Treatments for each type of diabetes insipidus include:
Central diabetes insipidus
If you have central diabetes insipidus, your treatment will most likely be desmopressin. Desmopressin is a man-made form of vasopressin and it helps to reduce the amount of urine your body produces. Your doctor may also treat any abnormalities to your pituitary gland or hypothalamus, this includes tumors and surgery may be needed for removal of them. Other medications may also be prescribed by your doctor as well. Mild forms of central diabetes insipidus may only need more fluid intake for treatment.
Nephrogenic diabetes insipidus
One of the common treatments for nephrogenic diabetes insipidus is taking hydrochlorothiazide, which is a diuretic. Hydrochlorothiazide can help to prevent your kidneys from losing too much water and they also help increase the concentration of urine produced. A diet with low levels of sodium is also an option to help reduce the amount of urine produced by your body. If nephrogenic diabetes is caused by certain medications like lithium, you may have to stop taking this drug or find alternative medications.
Dipsogenic diabetes insipidus
The treatment options for dipsogenic diabetes insipidus are limited to decreasing your fluid intake. If this form is caused by mental illness, treating the mental illness may help with symptoms too.
Gestational diabetes insipidus
If you have gestational diabetes insipidus, your doctor will most likely prescribe desmopressin for treatment. Gestational diabetes insipidus will usually go away a month to six weeks after your pregnancy although you may develop it again in subsequent pregnancies.
Diabetes insipidus is a rare condition that causes you to excrete water in your urine when your body needs it. Symptoms for diabetes insipidus include frequent urination, extreme thirst, and large amounts of urine although there are others. The causes for diabetes insipidus vary depending on the type you have and range from genetic factors to damage to your pituitary gland or hypothalamus. Treatment is also dependent on the type you have and include taking a synthetic form of vasopressin called desmopressin, removing any abnormalities from your pituitary gland or hypothalamus, regulating your fluid or water intake, a diet with low sodium levels, and other forms of medications. If you have any more questions, please talk to your doctor or health care professional.
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Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Erik Rivera and medically reviewed by Dr. Angel Rivera.
Owner, entrepreneur, and consumer health enthusiast.