Diabetes Insipidus
Introduction
Diabetes Insipidus (DI) is a body water balance disorder. DI, also called “water diabetes,” is not the same type of diabetes as “sugar diabetes,” or Type 1 Diabetes, Type 2 Diabetes, or Gestational Diabetes. The diseases resemble each other because both have similar symptoms of increased urination and increased thirst. Other than that, the diseases are completely unrelated. They have different causes and treatments.
DI is an uncommon condition. It occurs when the brain does not produce enough antidiuretic hormone (ADH) or when the ADH does not work with the kidneys like it should. As a result, people with DI can experience excessive urination, fluid intake, and thirst. If treated, severe complications and a reduced life expectancy may be avoided.
Anatomy
Your body continually works to keep your body fluids balanced. When fluid volumes need to increase, your body signals you to be thirsty. In turn, you consume more fluids.
Causes
Central DI, also known as Pituitary DI or Neurogenic DI, results in a lack of ADH production. Central DI is caused by damage to the pituitary gland or the hypothalamus. The damage can occur from neurosurgery, infection, diseases, brain injury, tumor, or genetic disorders.
With Nephrogenic DI the kidneys do not respond to ADH like they should. As a result, the kidneys do not return fluids back to the bloodstream. Nephrogenic DI can be caused by kidney disease, sickle cell disease, kidney failure, and certain drugs. Nephrogenic DI can be an inherited disorder, particularly in male children that inherit an abnormal gene from their mother. In some cases of Nephrogenic DI, the cause is not known.
Dipsogenic DI is caused by damage to the thirst mechanism located in the hypothalamus. People with Dipsogenic DI experience an abnormal increase in thirst. The excessive fluid intake suppresses ADH secretion. It also increases the amount of urine output, resulting in excess urination at night or bedwetting. Further, water intoxication can occur. Water intoxication is a condition that lowers the amount of sodium in the blood and can cause brain damage.
Gestational DI can develop in some women during pregnancy. The placenta, which supports the baby, exchanges nutrients and waste products with the mother to help the baby develop. Gestational DI results when an enzyme produced by the placenta destroys the ADH in the mother. In rare cases, an abnormality in the thirst mechanism causes Gestational DI. Gestational DI often resolves four to six weeks after pregnancy, but can develop again in future pregnancies.
Symptoms
Diagnosis
Treatment
The goal of treatment is to regulate the water balance in your body. This may be achieved in different ways, depending on the type of DI that you have.
Prevention
Am I at Risk
Certain underlying conditions are associated with the development of DI. However, people with an underlying cause of DI may never develop the disease. You should tell your doctor about your medical history and discuss your concerns.
Overall, underlying conditions associated with DI include injury to the pituitary gland or the hypothalamus in the brain. Such conditions include neurosurgery, infection, diseases, brain injury, tumor, or genetic disorders. Certain medications can cause DI. Such medications include lithium, amphotericin B, and demeclocycline. Additionally, Gestational DI can develop in women during pregnancy.
Complications
Dipsogenic DI can lead to water intoxication. Excessive water in the blood stream can cause low sodium levels in the blood and suppressed ADH production, resulting in a condition called hyponatremia. In severe cases, people can develop water intoxication. Water intoxication is very dangerous. Symptoms of water intoxication include shortness of breath, headache, confusion, loss of appetite, feeling tired all of the time, and nausea. It can lead to seizures, coma, and death.
Inadequate fluid consumption can result in dehydration and electrolyte imbalance. Symptoms of dehydration include dry skin, dry mouth, sunken appearing eyes, fever, rapid heart rate, and unintentional weight loss. Severe dehydration can lead to shock. Electrolytes are compounds that help to maintain body metabolism and function. Symptoms of an electrolyte imbalance include feeling tired all of the time, headache, irritability, and muscle pains.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.
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