Diabetes Insipidus


What is diabetes insipidus?

Despite the name, diabetes insipidus is not related to type 1 or type 2 diabetes (diabetes mellitus). Diabetes insipidus is a hormone disorder. It occurs when your body doesn’t produce enough antidiuretic hormone (ADH). It can also occur if your body doesn’t use the hormone effectively.

Symptoms of diabetes insipidus

Extreme thirst and excessive urination are the leading symptoms of diabetes insipidus. In a normal adult, the average amount of urine is 1.6 to 2.6 quarts per day. People who have diabetes insipidus may urinate up to 16 quarts a day. They may have to get up many times during the night to urinate. They may even wet the bed. Also, people with diabetes insipidus may seem confused. That can be because they’re dehydrated.

What causes diabetes insipidus?

Diabetes insipidus has several causes. In some people, a part of the brain (called the hypothalamus) doesn’t make enough ADH. ADH helps your body balance water in the urine and blood. In other cases, the pituitary gland (responsible for releasing ADH into the body) doesn’t release enough of the hormone. Damage to either the hypothalamus or the pituitary gland can cause diabetes insipidus. This can occur after a head injury, during brain surgery, or when a tumor grows on the glands.

Abnormalities in the kidneys can also cause diabetes insipidus. If the kidneys are abnormal, it can affect the way they process ADH. Diabetes insipidus can be caused by some medicines, such as lithium. About 30% of the time, doctors can’t find the cause.

How is diabetes insipidus diagnosed?

To check for diabetes insipidus, your doctor may order a urine test. This will show how much water is in your urine. It can rule out type 1 or type 2 diabetes. (If you have type 1 or type 2 diabetes, there will be excess sugar in your urine.) Your doctor might do a blood test to check for high sodium levels. This is another indication of diabetes insipidus.

Your doctor may also order a water deprivation test. This test can take several hours. You aren’t allowed to drink any liquids during this time. Your weight, urine and blood will be checked every hour. If the results of this test show you have diabetes insipidus, you’ll probably need more tests. Your doctor will likely order pictures of your brain using an MRI (magnetic resonance image) scan. The scan can show problems in the brain that could be causing your diabetes insipidus.

Can diabetes insipidus be prevented or avoided?

Most of the time, diabetes insipidus is a permanent condition. You likely won’t be able to prevent it. Most often, this condition is associated with another health problem. It can be associated with abnormal kidney function or tumors. Even though you can’t prevent it in these cases, you can often manage the symptoms.

Diabetes insipidus treatment

If your symptoms are mild, you might not need treatment. However, your doctor will want to check on you more often. You should make sure you always have something to drink. This will ensure that your body doesn’t get dehydrated.

For more severe cases of diabetes insipidus, your doctor may prescribe medicine. This medicine will help your body produce or more effectively use ADH. One medicine called desmopressin is a synthetic form of ADH. Desmopressin comes in pill form, as a shot, or as a nasal spray. If you take desmopressin, you shouldn’t drink too much. Drinking too much will overload your body with fluids. Too much fluid in your body can make you feel sick, weak, or dizzy.

Your diabetes insipidus could be caused by kidney problems. If so, your doctor may recommend that you reduce salt in your diet. You’ll also need to drink enough water to avoid dehydration. Medicines like hydrochlorothiazide (a water pill) may also help. Water pills help your body balance salt and water.

Your diabetes insipidus could be caused by tumors or abnormal growths on your hypothalamus or pituitary gland. If so, your doctor may suggest surgery to remove the growths.

If a medicine is causing diabetes insipidus, your doctor may prescribe another type. He or she will look for a medicine that won’t cause excessive thirst and urination.

Talk to your doctor about which option is right for you.

Living with diabetes insipidus

There is no cure for diabetes insipidus. But you can work with your doctor to manage the symptoms of this condition. Medicine can help prevent the constant thirst and excessive urination that comes with this condition. Preventing these symptoms will add a great deal to your quality of life.

Questions to ask your doctor

  • What is the likely cause of my diabetes insipidus?
  • What’s the best treatment option for me? Will I need medicine? Surgery?
  • What are the risks and benefits of this treatment option?
  • How soon can I expect my symptoms to go away?
  • Does diabetes insipidus put me at risk for any other health problems?
  • Do I need to make any lifestyle changes?