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Diabetes Insipidus: Symptoms & Causes

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 common Diabetes insipidus symptoms . DI is caused due to a problem with a hormone called antidiuretic hormone (ADH, or vasopressin). The body doesn't adequately produce ADH, and the kidneys don't utilize it correctly.

In severe cases, a person may excrete up to 30 litres 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 bodies.

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 of Diabetes Insipidus

Insipidus has two basic categories, which are as follows:

  • Nephrogenic diabetes insipidus: NDI occurs when the kidneys are unable to respond properly to vasopressin, even when it is present in normal or elevated amounts.
    This type of diabetes insipidus can be caused by genetic mutations, kidney disorders, certain medications (such as lithium or certain diuretics), and electrolyte imbalances.
  • Central diabetes insipidus: CDI occurs when there is a deficiency in the production or release of vasopressin (antidiuretic hormone) from the hypothalamus or pituitary gland.
    This type of diabetes insipidus is often caused by damage to the hypothalamus or pituitary gland due to injury, surgery, tumor, or other conditions.

Symptoms of Diabetes Insipidus

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:

When to see a doctor?

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

Causes of Diabetes Insipidus

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

    • Risk Factors of Diabetes Insipidus

    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 of Diabetes Insipidus

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

    Preventions of Diabetes Insipidus

    Dehydration is a severe consequence of diabetic insipidus. Drinking more liquids may prevent dehydration. 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. Depending on the patient's health and risk factors, the doctor could suggest a specific type of immunization.

    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.
    • Avoid touching your mouth, nose, or eyes with unwashed hands.
    • Sleep for eight hours every night.
    • Regular exercise helps boost the immune system.

    Diagnosis of Diabetes Insipidus

    The doctor will do a physical examination, review medical history, and ask about diabetes insipidus symptoms. They can also suggest specific 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 diabetes 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, MRI scans and other imaging tests are performed.
    • 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 for diabetes insipidus

    The diabetes insipidus treatment includes:

    • The doctor decides on 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’sDon’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 doctorFollow self medication

    Diabetes Insipidus Care at Medicover Hospitals

    Our team of general physicians at Medicover hospitals is the best in the business and has extensive expertise in treating Diabetes Insipidus. Our highly qualified healthcare professionals treat all types of Diabetes Insipidus and its symptoms using the most up-to-date medical tools, techniques, and technology. We use a multidisciplinary approach to give patients complete treatment and respond to their medical needs for a quicker and more lasting recovery.

    Citations

    https://www.niddk.nih.gov/health-information/kidney-disease/diabetes-insipidus
    https://www.nhs.uk/conditions/diabetes-insipidus/
    https://emedicine.medscape.com/article/117648-overview
    https://www.karger.com/article/fulltext/336333
    https://www.rch.org.au/clinicalguide/guideline_index/Diabetes_insipidus/
    https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetes-insipidus
    https://pituitary.org.uk/information/pituitary-conditions/diabetes-insipidus/
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    Frequently Asked Questions

    1. What is Diabetes Insipidus (DI)?

    Diabetes Insipidus is a rare condition characterized by excessive thirst and excessive urination due to an inability to properly regulate body fluids.

    2. What are the different types of Diabetes Insipidus?

    There are four primary types: central DI, nephrogenic DI, gestational DI, and primary polydipsia.

    3. Can you explain Central Diabetes Insipidus (CDI)?

    CDI occurs when the hypothalamus or pituitary gland fails to produce or release sufficient antidiuretic hormone (ADH), leading to excessive urination and thirst.

    4. What is Nephrogenic Diabetes Insipidus (NDI)?

    NDI results from the kidneys' inability to respond to ADH, leading to excessive urination despite normal hormone levels.

    5. Is Gestational Diabetes Insipidus temporary or chronic?

    Gestational DI typically occurs during pregnancy and is usually temporary, resolving after childbirth.

    6. What causes Primary Polydipsia (excessive thirst) in Diabetes Insipidus?

    Primary Polydipsia often occurs due to excessive fluid intake, which overwhelms the body's ability to concentrate urine.

    7.What is the difference between diabetes mellitus and diabetes insipidus?

    Diabetes mellitus involves elevated blood sugar due to insulin deficiency or resistance, while diabetes insipidus is characterized by excessive urination and thirst caused by vasopressin deficiency or kidney insensitivity to it.

    8. How to detect diabetes insipidus?

    Diabetes insipidus can be detected through urine and blood tests measuring urine output, urine concentration, and levels of vasopressin and electrolytes.

    9.Which hormone deficiency causes diabetes insipidus?

    Diabetes insipidus results from a deficiency in the hormone vasopressin, also known as antidiuretic hormone (ADH).

    10. Does diabetes insipidus affect blood sugar?

    No, diabetes insipidus does not directly affect blood sugar levels as it involves abnormalities in water balance regulated by vasopressin, not insulin or glucose metabolism.


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