Diabetes Insipidus

Diabetes insipidus (DI), also called water diabetes, is an uncommon but manageable condition in which the body produces excess urine and cannot retain water properly. Diabetes insipidus can be life-long or temporary and mild or extreme relying on the underlying cause.

Extreme thirst and excessive urination are two symptoms of Diabetes insipidus. DI is caused due to a problem with a hormone called antidiuretic hormone (ADH, or vasopressin). The body doesn’t adequately produce ADH or the kidneys don’t utilize it correctly.

In severe cases, a person may excrete up to 30 liters of urine daily. If left untreated, diabetes insipidus can result in dehydration and, eventually, coma due to the high concentration of salts in the blood, especially sodium. Generally, DI does not cause major problems, and patients may control the condition by maintaining a healthy hydration level in their body.

This can be more challenging for those who may have trouble managing their thirst, like newborns or older adults. These people may experience serious consequences, such as confusion, seizures or brain trauma.

Types

Insipidus has two basic categories, which are as follows:

Nephrogenic diabetes insipidus
Central diabetes insipidus

Symptoms

The most common symptoms of Diabetes Insipidus in adults are:

Extreme undying thirst (polydipsia)
Frequent urination (polyuria)
Nocturia – waking up frequently at night to urinate
Bed-wetting
Dry skin

Constipation
Weak muscles

In infants and small children the symptoms are:

Diarrhea
Fever
Vomiting
Crying uncontrollably
Trouble sleeping
Weight loss
Delayed growth

When to see a doctor?

If you have an extreme thirst and frequent urination, consult a doctor immediately.

Causes

Our kidneys work hard by filtering the blood, reabsorbing most of the water, and just a small quantity of concentrated urine is excreted. Diabetes insipidus is a condition in which diluted urine is removed from the body due to the kidneys' inability to concentrate it properly.

Diabetes insipidus results due to issues with a hormone called vasopressin (AVP) or antidiuretic hormone (ADH). It is made by the hypothalamus and accumulated in the pituitary gland until required.

AVP hormone controls the water level in the body by handling the urine amount the kidneys produce. In DI, AVP fails to regulate your body's water level and lets excessive urine be produced and passed out from the body.

Risk Factors

Individuals of all generations can develop diabetes insipidus. The risk factors are as follows:

Having a family history
In case of brain surgery or a major head injury.
Medicines that can cause kidney problems.
In metabolic conditions (high blood calcium or low blood potassium levels).

Complications

Diabetes insipidus increases the risk of health problems like:

Dehydration:

With diabetes insipidus, the body has trouble retaining water.

Electrolyte imbalance:

The body's electrolytes are unbalanced resulting in:

Less sleep:

Nocturia, the medical term for getting up in the middle of the night to urinate can result in sleep disorders.

Preventions

Dehydration is a severe consequence of diabetic insipidus. By drinking more liquids, you may avoid being dehydrated. Seek immediate medical attention if you exhibit dehydration symptoms, including disorientation, dizziness, or sluggishness.

There are many vaccine options, including nasal spray and conventional jabs. The doctor could suggest a specific type of immunization depending on the health and risk factors.

Other prevention methods are:

Follow healthy habits, such as washing your hands with soap and water.
Use a disinfectant to clean surfaces and items like furniture and toys.
Covering your mouth while coughing and sneezing will help reduce the risk of infection.
Avoiding touching mouth, nose, or eyes with unwashed hands.
Sleep for eight hours every night.
Regular exercise helps boost the immune system.

Diagnosis

The doctor will do a physical examination, review medical history, and ask about symptoms. They can also suggest certain tests, such as:

Urinalysis:

This test examines whether the urine is too diluted. It may also test urine glucose levels to differentiate between diabetes mellitus and insipidus.

Blood tests:

This test measures electrolyte levels and other compounds in the blood. They could also be used to identify a particular form of diabetes insipidus.

Water deprivation test:

This involves restricting yourself from all liquids over some time to cause dehydration. The amount of urine they produce, their weight, and any changes in blood and urine will all be measured by a doctor after that. During the exam, they may also administer vasopressin or other medications, and this might also aid in determining the origin of Diabetes insipidus.

Imaging tests:

To detect any damage to the hypothalamus or pituitary gland, imaging tests, such as MRI scans are done.

Stimulation tests:

The body is stimulated to create vasopressin by a solution that a physician gives. Copeptin, a chemical that rises with vasopressin, will then be measured in the blood. Results can help distinguish between Diabetes insipidus and primary polydipsia, a separate illness that can also make individuals consume a lot of fluids.

Treatment

The diabetes insipidus treatment includes:

The doctor decides treatment according to the severity of the condition. Drinking enough water can help manage mild diabetic insipidus and keep the body hydrated.
Among other medications, vasopressin related hormones, diuretics, anti convulsant, and antidiabetic medicines treat central diabetic insipidus. These medications enhance the kidneys' capacity to retain water.
Vasopressin related hormones are beneficial for treating children.
Some methods for treating nephrogenic diabetes include maintaining the body's sodium levels and, consequently, its water content.
Nonsteroidal anti-inflammatory medications are also used as a kind of therapy. NSAIDS and thiazides are used to treat children with nephrogenic diabetes insipidus.
It is essential to regularly monitor patients throughout the treatment process to spot signs of electrolyte imbalance and water intoxication.

Dos and Don’ts

Diabetes insipidus causes excessive thirst and increased urination, especially at night, which interferes with everyday life. These dos and don'ts can help in managing the symptoms and to control the condition.

Do’s	Don’ts
Keep yourself hydrated	Eat excessive salty foods
Eat a healthy diet	Drink carbonated and caffeinated drinks
Reduce salt and protein the diet	Drink less water
Avoid eating processed or junk foods	Include excessive protein in the diet
Take the medications as prescribed by your doctor	Follow self medication