Diabetes Insipidus - Causes, Symptoms and Treatment

04 Jul

Posted by admin as diabetes

Diabetes Insipidus (DI) is a disorder in which there is an abnormal increase in urine output, fluid intake and often thirst. It causes symptoms such as urinary frequency, nocturia (frequent awakening at night to urinate) or enuresis (involuntary urination during sleep or “bedwetting”). Urine output is increased because it is not concentrated normally. Consequently, instead of being a yellow color, the urine is pale, colorless or watery in appearance and the measured concentration (osmolality or specific gravity) is low.

Signs And Symptoms Of Diabetes Insipidus

Excessive urination and extreme thirst (especially for cold water and sometimes ice or ice water) are typical for DI. Symptoms of diabetes insipidus are quite similar to those of untreated diabetes mellitus, with the distinction that the urine is not sweet as it does not contain glucose and there is no hyperglycemia (elevated blood glucose).

Depending on the severity of the condition, urine output can range from 2.5 liters per day if you have mild diabetes insipidus to 15 liters per day if the condition is severe and if you’re taking in a lot of fluids. In comparison, the average urine output for a healthy adult is in the range of 1.5 to 2.5 liters a day.

Causes Of Diabetes Insipidus

Diabetes insipidus (DI) is an uncommon condition that occurs when the kidneys are unable to conserve water as they perform their function of filtering blood. The amount of water conserved is controlled by antidiuretic hormone (ADH), also called vasopressin.

ADH is a hormone produced in a region of the brain called the hypothalamus.

Central diabetes insipidus may be caused by insufficient production of antidiuretic hormone by the hypothalamus. Alternatively, the disorder may be caused by failure of the pituitary gland to release antidiuretic hormone into the bloodstream.

Treatment Of Diabetes Insipidus

Medical Care

In an emergency, most patients with diabetes insipidus (DI) can drink enough fluid to replace their urine losses. Replace losses with dextrose and water or IV fluid hyposmolar to the patient’s serum. Avoid hyperglycemia, volume overload, and a correction of hypernatremia that is too rapid. A good rule of thumb is to reduce serum sodium by 0.5 mmol/L/h. Water deficit may be calculated based on the assumption that body water is approximately 60% of body weight in kilograms.

If your diabetes insipidus is caused by kidneys that don’t work well with ADH, then DDAVP won’t help. Other medicines, like hydrochlorothiazide (a “water” pill), may help. Water pills help your body balance salt and water.