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Diabetes Insipidus

What is diabetes insipidus (DI)?

Diabetes insipidus is a condition that results from insufficient production of the antidiuretic hormone (ADH), a hormone that helps the  body conserve the correct amount of water. Diabetes insipidus is not related to the more common type of diabetes called diabetes mellitus. Normally, ADH controls the kidneys' output of urine. ADH is secreted by the hypothalamus (a small gland located at the base of the brain), stored in the pituitary gland and then released into the bloodstream. ADH is secreted to decrease the amount of urine output so that dehydration does not occur. Diabetes insipidus, however, results in excessive production of very diluted urine and excessive thirst. The disease is categorized into groups based on cause. The groups are described below:

  • Central diabetes insipidus. This condition is caused by insufficient production or secretion of pituitary ADH; it can be a result of damage to the hypothalamus or pituitary gland caused by head injuries, genetic disorders, and other diseases.

  • Nephrogenic diabetes insipidus. This condition is the result of a lack of kidney response to normal levels of ADH: it can be caused by drugs or chronic disorders, such as kidney failure, sickle cell disease, or polycystic kidney disease.

  • Dipsogenic diabetes insipidus. This conditions is caused by a problem with the thirst feedback mechanism in the hypothalamus. This defect results in abnormal increases in fluid intake and thirst that suppresses ADH production.

  • Gestational diabetes insipidus. This occurs only in pregnant women when an enzyme made by the placenta destroys ADH in the mother.

What are the symptoms of diabetes insipidus?

The following are the most common symptoms of diabetes insipidus. However, each individual may experience symptoms differently. Symptoms may include:

  • Excessive thirst

  • Excessive urine production

  • Dehydration

The symptoms of diabetes insipidus may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is diabetes insipidus diagnosed?

In addition to a complete medical history and medical examination, diagnostic procedures for diabetes insipidus may include:

  • Urine tests

  • Blood tests

  • A formal water deprivation test (to observe if dehydration occurs) and help differentiate which DI one has.

What is the treatment for diabetes insipidus?

Treatment for diabetes insipidus depends on what is causing the disease. Treatment may include modified antidiuretic hormone drugs or drugs to stimulate the production of ADH in central Di and gestational DI. In nephrogenic DI, other specific medicines are used. All treatments include specific fluid intake. There is no known treatment for dipsogenic DI.