Diabetes Insipidus

For the most part, when the word "diabetes" comes up in conversation, it is usually about the condition where the blood sugar is elevated. This is also known as diabetes mellitus. Interesting enough the word "diabetes" by itself stands for too much urine production and the name on the end is the actual condition. Diabetes mellitus causes increased urine production because the body is trying to rid itself of excess sugar. There is another diabetes condition where someone does not have excess sugar, but still produces more urine than normal and this is known as diabetes insipidus.

Diabetes insipidus is caused by a defective hormone or receptor and makes the body produce too much urine. It can cause dehydration if left untreated. Read on to learn more about this condition.

What Is Diabetes Insipidus?

When you have diabetes insipidus, your kidneys cannot regulate the water balance in your body. They tend to lose too much urine and they fail to concentrate it. When you pass too much urine, it is known as, polyuria. Your body tries to compensate, making you thirstier. In diabetes insipidus, your balance of sodium and potassium are disturbed and you can become dehydrated very easily. It is important to understand that diabetes mellitus and diabetes insipidus are in no way related and are two completely different conditions.

What Are the Symptoms of Diabetes Insipidus?

Symptoms of diabetes insipidus include:

  • Very thirsty
  • Urinating large volumes of urine that is not concentrated (2 liters per day up to 20 liters per day), while the average person urinates between 1.5 and 2.5 liters per day
  • Needing to urinate during the night (nocturia)
  • Bedwetting

If you suspect DI in a child, they may have the following symptoms:

  • Severe fussiness and crying
  • Large amounts of wet diapers or wetting through diapers constantly
  • Chronic fevers, diarrhea and vomiting
  • Cool extremities and dry skin
  • Slow growth rate
  • Weight losses instead of gains

Complications

Excessive urination can cause complications in the body and they can set in fairly quickly. If you have any of the following complications, you should seek medical attention.

  1. Electrolyte Imbalance

If you have diabetes insipidus, the constant urination can "wash-out" important electrolytes like sodium and potassium and this can be life threatening. Symptoms of low electrolytes are:

  • Weakness, fatigue and lethargy
  • Pain in the muscles
  • Irritable mood
  • Nausea
  • Poor appetite
  1. Dehydration

Even though you are drinking excessive fluids, you are losing them with excessive urination and the body is unable to retain needed fluids. This leads to dehydration and the symptoms include:

  • Rapid weight loss (over 5 pounds in one to two days)
  • Fast heartbeat
  • Sunken eyes
  • Fever
  • Headache
  • Mouth dryness
  • Weak muscles
  • High sodium in the blood
  • Low Blood Pressure

Any of the above symptoms could be life threatening. Call your doctor immediately or go to your nearest emergency room.

When to See a Doctor

If you're constantly thirsty and urinating more than normal, you should make an appointment with your doctor. Normal urination is about 4 to 7 times a day. While children may urinate more often because of small bladders, they usually urinate about 10 times a day.

What Are the Causes & Risk Factors of Diabetes Insipidus?

The reason for the urine dysfunction in the body may come from a few different places in the body. Here are the different types of diabetes insipidus with their causes.

Type

Causes

Central Diabetes Insipidus

This type is caused by a problem rooted in the pituitary gland in the brain. The pituitary gland produces anti-diuretic hormone (ADH) that helps to regulate fluid balance in the body. In central diabetes insipidus the production and release of ADH is altered in some way. It could be caused by a head injury, swelling in the brain, pituitary tumor or lack of blood flow to the pituitary gland.

Nephrogenic Diabetes Insipidus

This type of DI actually comes from the kidneys when they cannot respond properly to ADH. Medications such as tetracycline or lithium can cause this. Other conditions like high calcium in the blood, polycystic kidney disease and sickle cell anemia can also affect the kidneys. It can also be caused by rare genetic kidney disease.

Gestational Diabetes Insipidus

In the gestational form of this disorder, the placenta makes a certain enzyme that competes against ADH. The job of the placenta is to nourish the baby and remove waste to filter out through the mother's kidneys. In gestational diabetes insipidus this process is somewhat interrupted, but it is hard to determine why.

Dipsogenic Diabetes Insipidus

This is when the thirst mechanism in the brain malfunctions and makes you extra thirsty. It is believed to sometimes be caused by mental illness or an inflammatory disorder known as sarcoidosis.

Risk Factors

There are a few risk factors for diabetes insipidus. While it doesn't mean that you will actually get it, if you have had any of the following you might be predisposed to the condition:

  • Kidney disease (kidney stones, kidney failure or other kidney malfunctions)
  • Brain surgery
  • Head injury
  • Brain infection
  • Diabetes Insipidus in the family

What Are the Treatments for Diabetes Insipidus?

Treatments are different for each form of Diabetes Insipidus. Here are the treatments according to the type:

Type

Treatments

Central Diabetes Insipidus

Since this is an actual lack of anti-diuretic hormone, the synthetic version, desmopressin is given via nasal spray, shots or pills by mouth. The hormone replacement helps to stop excessive urination. Surgery can also be performed i.e. removal of any tumors. If DI is mild, the treatment only involves drinking extra fluids.

Nephrogenic Diabetes Insipidus

Since this type is located in the kidneys, taking synthetic ADH would not help and could make you sicker. Treatment consists of a low-salt diet so the kidneys don't make as much urine. This type requires increased fluid intake and the doctor may prescribe hydrochlorothiazide, a drug that can possibly reduce urine production in those who have diabetes insipidus. Medication related nephrogenic diabetes insipidus may be treated by changing medications or stopping the offending drug. This should only be done under a doctor's supervision.

Gestational Diabetes Insipidus

Gestational diabetes insipidus can often be treated with the synthetic hormone, desmopressin. If the condition is related to the thirst mechanism during pregnancy, the hormone will not be prescribed.

Primary Polydipsia

This type of diabetes insipidus can only be treated by decreasing the amount of fluids taken in. If the condition is related to a mental condition, psychiatric treatment may be needed.

Watch this informative video on diabetes insipidus:

 

 
 
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