Diabetes Insipidus

Diabetes insipidus is a rare but treatable condition in which your body produces too much urine and isn’t able to properly retain water. Diabetes insipidus can be chronic (life-long) or temporary and mild or severe depending on the cause.

Causes of Diabetes Insipidus

  • Damage to your hypothalamus or your pituitary gland from surgery.

  • Damage to your hypothalamus or pituitary gland from a head injury, particularly basal skull fractures.

  • Inflammation (granulomas) from sarcoidosis or tuberculosis.

  • Tumors that affect your hypothalamus or pituitary gland.

  • An autoimmune reaction that causes your immune system to damage healthy cells that make an antidiuretic hormone (ADH).

  • An inherited gene mutation on chromosome 20.

  • Certain medications, such as lithium and tetracycline.

  • Low levels of potassium in your blood (hypokalemia).

  • High levels of calcium in your blood (hypercalcemia).

  • A blocked urinary tract.

Symptoms of Diabetes Insipidus

The main symptoms of diabetes insipidus include:

  • Needing to pee often, including through the night.

  • Passing large amounts of light-colored or clear urine each time you pee.

  • Feeling very thirsty and drinking liquids very often.

  • While most people produce one to three quarts of urine a day, people with diabetes insipidus can produce up to 20 quarts of urine a day.

If diabetes insipidus isn’t treated or if a person with diabetes insipidus stops drinking fluids, it can quickly lead to dehydration.

Symptoms of dehydration include:

  • Feeling dizzy or lightheaded.

  • Feeling tired.

  • Having a dry mouth, lips and eyes.

  • Difficulty performing simple mental tasks.

  • Nausea.

  • Fainting.

Diagnosis of Diabetes Insipidus

  • Blood test to check antidiuretic hormone (ADH, or vasopressin) levels.

  • Blood test to check glucose levels to rule out diabetes mellitus.

  • Urinalysis to check osmolality (the concentration of your urine) and/or to check for ketones, which could indicate diabetes mellitus.

  • Imaging tests, such as an MRI, to see if issues with your pituitary gland or hypothalamus are causing your diabetes insipidus.

Complications of Diabetes Insipidus

  • The main complication of diabetes insipidus is dehydration, which happens when your body loses too much fluid and electrolytes to work properly.

  • If you have diabetes insipidus, you can usually make up for the significant volume of fluids you pass in your urine by drinking more liquids.

  • But if you don’t, you could quickly become dehydrated.

  • Dehydration is dangerous and can be life-threatening.

  • If you’re experiencing symptoms of dehydration, such as feeling dizzy, nauseous and sluggish, get to the nearest hospital as soon as possible.

Treatment of Diabetes Insipidus

  • Desmopressin is the first-line treatment for central diabetes insipidus.

  • It’s a medication that works like an antidiuretic hormone (ADH, or vasopressin).

  • You can take desmopressin as an injection (shot), a pill or in a nasal spray.

  • Healthcare providers often treat it with medications called thiazide diuretics, which reduce the amount of urine your kidneys produce.

  • Your provider may also suggest taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help further reduce urine volume when they’re used in combination with thiazide diuretics.

  • If your medication causes nephrogenic diabetes insipidus, your healthcare provider can sometimes treat it by changing your medication.

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