Diabetes Insipidus is rare and causes an imbalance of water in the body. It exhibits through extreme thirst as well as peeing alot. There is no cure.
The most common signs and symptoms of diabetes insipidus are:
- Extreme thirst
- Excretion of an excessive amount of diluted urine
Infants and young children who have diabetes insipidus may have the following signs and symptoms:
- Unexplained fussiness or inconsolable crying
- Trouble sleeping
- Fever
- Vomiting
- Diarrhea
- Delayed growth
- Weight loss
Normally, your kidneys remove excess body fluids from your bloodstream. This fluid waste is temporarily stored in your bladder as urine, before you urinate.
When your fluid regulation system is working properly, your kidneys conserve fluid and make less urine when your body water is decreased, such as through perspiration.
The volume and composition of your body fluids remain balanced through a combination of oral intake and excretion by the kidneys. The rate of fluid intake is largely governed by thirst, although your habits can increase your intake far above the amount necessary. The rate of fluid excreted by your kidneys is greatly influenced by the production of anti-diuretic hormone (ADH), also known as vasopressin.
Your body makes ADH in the hypothalamus and stores the hormone in your pituitary gland, a small gland located in the base of your brain. ADH is released into your bloodstream when your body starts to become dehydrated. ADH then concentrates the urine by triggering the kidney tubules to release water back into your bloodstream rather than excreting as much water into your urine.
The way in which your system is disrupted determines which form of diabetes insipidus you have:
- Central diabetes insipidus. The cause of central diabetes insipidus in adults is usually damage to the pituitary gland or hypothalamus. This damage disrupts the normal production, storage and release of ADH.
The damage is commonly due to surgery, a tumor, an illness (such as meningitis), inflammation or a head injury. For children, the cause may be an inherited genetic disorder. In some cases the cause is unknown. - Nephrogenic diabetes insipidus. Nephrogenic diabetes insipidus occurs when there's a defect in the kidney tubules — the structures in your kidneys that cause water to be excreted or reabsorbed. This defect makes your kidneys unable to properly respond to ADH.
The defect may be due to an inherited (genetic) disorder or a chronic kidney disorder. Certain drugs, such as lithium or the antiviral medications cidofovir and foscarnet (Foscavir), also can cause nephrogenic diabetes insipidus. - Gestational diabetes insipidus. Gestational diabetes insipidus is rare and occurs only during pregnancy and when an enzyme made by the placenta — the system of blood vessels and other tissue that allows the exchange of nutrients and waste products between a mother and her baby — destroys ADH in the mother.
- Primary polydipsia. This condition — also known as dipsogenic diabetes insipidus or psychogenic polydipsia — can cause excretion of large volumes of dilute urine. Rather than a problem with ADH production or damage, the underlying cause is intake of excessive fluids.
Prolonged excessive water intake by itself can damage the kidneys and suppress ADH, making your body unable to concentrate urine. Primary polydipsia can be the result of abnormal thirst caused by damage to the thirst-regulating mechanism, situated in the hypothalamus. Primary polydipsia has also been linked to mental illness.
Treatment of diabetes insipidus depends on what form of the condition you have. Treatment options for the most common types of diabetes insipidus include:
- Central diabetes insipidus. Because the cause of this form of diabetes insipidus is a lack of anti-diuretic hormone (ADH), treatment is usually with a synthetic hormone called desmopressin. You can take desmopressin as a nasal spray, as oral tablets or by injection.
The synthetic hormone will eliminate the increase in urination. For most people with this form of the condition, desmopressin is safe and effective. If the condition is caused by an abnormality in the pituitary gland or hypothalamus (such as a tumor), your doctor will first treat the abnormality. - Desmopressin should be considered a medication you take as needed. This is because in most people, the deficiency of ADH is not complete, and the amount made by the body can vary day to day.
- Taking more desmopressin than needed can result in too much water retention and low sodium levels in the blood. Symptoms of low sodium include lethargy, headache, nausea and, in severe cases, seizures.
- In mild cases of central diabetes insipidus, you may need only to increase your water intake.
- Nephrogenic diabetes insipidus. This condition is the result of your kidneys not properly responding to ADH, so desmopressin is not a treatment option. Instead, your doctor may prescribe a low-salt diet to help reduce the amount of urine your kidneys make. You'll also need to drink enough water to avoid dehydration.
- The drug hydrochlorothiazide, used alone or with other medications, may improve symptoms. Although hydrochlorothiazide is a diuretic (usually used to increase urine output), in some cases it can reduce urine output for people with nephrogenic diabetes insipidus.
- If symptoms from nephrogenic diabetes insipidus are due to medications you're taking, stopping these medicines may help; however, don't stop taking any medication without first talking to your doctor.
- Gestational diabetes insipidus. Treatment for most cases of gestational diabetes insipidus is with the synthetic hormone desmopressin. In rare cases, this form of the condition is caused by an abnormality in the thirst mechanism. In these rare cases, doctors don't prescribe desmopressin.
- Primary polydipsia. There is no specific treatment for this form of diabetes insipidus, other than decreasing the amount of fluid intake. However, if the condition is caused by mental illness, treating the mental illness may relieve the symptoms.
