Diabetes Insipidus

What is diabetes insipidus?

Diabetes insipidus occurs when your body doesn’t make enough antidiuretic hormone (ADH) or your kidneys don’t respond to it. ADH helps keep the right amount of water in your body. Normally, ADH controls how much urine your kidneys put out. This keeps you from losing too much water (being dehydrated). If you are a bit dehydrated, ADH should increase.

ADH is made by the hypothalamus, a small gland at the base of the brain. It is stored in the pituitary gland and then sent into the bloodstream as needed.

Diabetes insipidus is not related to the more common type of diabetes (diabetes mellitus).

What is the cause of diabetes insipidus?

There are several types of diabetes insipidus:

  • Central. This type occurs when the pituitary doesn’t make or send out enough ADH. It can happen if the hypothalamus or pituitary gland are damaged. This can be caused by a head wound (including surgery on the pituitary gland,) a genetic problem, and other diseases.
  • Nephrogenic. This type occurs when the kidneys don’t respond to normal levels of ADH. It can be caused by medicines or lifelong (chronic) disorders such as kidney disease or sickle cell disease.
  • Dipsogenic. This type occurs when there is damage to the mechanism that controls thirst, found in the hypothalamus. As a result you are too thirsty and drink too many fluids. This slows down ADH production.
  • Gestational. This occurs only in pregnant women. In this type, an enzyme made by the placenta destroys ADH in the mother.

What are the symptoms of diabetes insipidus?

Common symptoms may include:

  • Being very thirsty
  • Making too much urine
  • Dehydration

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is diabetes insipidus diagnosed?

Your provider will take your health history and give you a physical exam. You may also need the following tests:

  • Urine tests
  • Blood tests to see how your pituitary and kidneys react to dehydration (called a formal water deprivation test)

How is diabetes insipidus treated?

Your healthcare provider will figure out the best treatment for you based on:

  • Your age, overall health, and medical history
  • How sick you are
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • Your opinion or preference

Treatment for diabetes insipidus depends on what is causing it:

  • For central and gestational types, treatment may include taking modified ADH medicines or medicines to stimulate ADH production.
  • In nephrogenic diabetes insipidus, other medicines are used.
  • For all types, specific fluid intake is needed.
  • There is no known treatment for dipsogenic diabetes insipidus.

What are the complications of diabetes insipidus?

If you don’t drink enough fluids, you can get dehydrated. You can also have an electrolyte imbalance. This means not having the right balance of minerals in your body.

Dehydration can cause:

  • Dry skin
  • Dry mouth, nose, and sinuses
  • Fever
  • Rapid heart rate
  • Eyes can appear sunken
  • Weight loss

Electrolyte imbalance can cause:

  • Tiredness
  • Headache
  • Muscle pains
  • Feeling very tired
  • Being grouchy (irritable)
  • Irregular heartbeat

Living with diabetes insipidus

It’s important to follow your healthcare provider’s advice on medicines and fluid intake to prevent problems.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, call your healthcare provider right away.

Key points

  • Diabetes insipidus occurs when your body doesn’t make enough antidiuretic hormone (ADH). It is a rare disease that causes you to urinate often.
  • It is not related to the more common type of diabetes (diabetes mellitus).
  • Symptoms may include extreme thirst and urine production, and dehydration.
  • You may need to have blood tests and urine tests.
  • Treatment depends on what is causing the disease. It includes replacing ADH with medicines.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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