Symptoms, Causes, Diagnosis, and Treatment

Diabetes insipidus is a rare condition that causes sufferers to feel thirsty and have the urge to urinate frequently. Get to know more about this disease, from symptoms to treatment in the following review.

What is Diabetes Insipidus?

Diabetes insipidus is a condition in which the kidneys cannot store fluids properly. This condition can make a person excessively thirsty and urinate frequently.

Despite having almost the same name, diabetes insipidus has nothing to do with diabetes mellitus. If a person with diabetes mellitus has a problem with the hormone insulin, the body of a person with diabetes insipidus is disturbed by a hormone known as antidiuretic hormone (ADH or vasopressin).

This condition causes people with this condition to urinate frequently, even up to 20 liters per day. For the record, healthy adults usually urinate between 1-3 liters per day.

Symptoms of Diabetes Insipidus

There are two main symptoms of this condition, including:

• Polydipsia: Excessive thirst so that sufferers want to drink in unnatural limits.
• Polyuria: Excessive production of urine in the body resulting in an excessive urge to urinate.

Meanwhile, diabetes insipidus that afflicts children can cause the following symptoms:

• Excessive thirst.
• Fussy and irritable.
• Dehydration.
• Wet in unusual diapers, wetting the bed, passing excessive urine.
• Dry skin.
• High fever.
• Developmental disorders.

If it affects adults, the symptoms mentioned above can occur. In addition, there are several other signs, including:

• Dizzy.
• Confusion.
• Sluggish.
• Severe dehydration leading to seizures and brain damage.

If the condition is severe and left untreated, death can occur.

When to See a Doctor?

See a doctor immediately if you feel constantly thirsty. Although the cause is not necessarily diabetes insipidus, it needs to be treated.

Examination should also be done immediately if you urinate more and more frequently than usual; or you always feel like you have to pee, even if you don’t pass a small amount of urine.

This also applies to children. Even if he has a smaller bladder and urinates frequently, consult a doctor if he urinates more than 10 times a day.

Also Read: Recognize the 3 Types of Diabetes That Can Attack You

Causes of Diabetes Insipidus

Diabetes insipidus occurs when the hormone vasopressin (AVP) or antidiuretic hormone (ADH) is disrupted. This hormone plays an important role in regulating the amount of fluid in the body.

The pituitary gland will secrete AVP when the amount of fluid in the body is very small. This hormone can help retain fluids in the body by reducing the amount of water excreted through the kidneys. This condition causes the kidneys to produce more concentrated urine.

In people with diabetes insipidus, the body does not produce enough AVP hormones. As a result, the kidneys do not produce concentrated urine and the body excretes too much fluid.

In rare cases, the kidneys cannot use the AVP hormone properly. This condition is known as nephrogenic diabetes insipidus.

Diagnosis of Diabetes Insipidus

Before determining the diagnosis, the doctor will ask about the symptoms experienced. After that, several supporting tests can be carried out to make a diagnosis.

There are a number of supporting checks, including:

1. Urine Gravity Test

The urine sample will be tested to determine the concentration of salt and other wastes contained in it. This test is also known as a urine specific gravity test.

If it is proven that you have diabetes insipidus, the concentration of water will be higher, while the concentration of other wastes will be lower. In addition, the specific gravity of your urine will be lower.

2. Water Deprivation Test

Before carrying out this test, your doctor will ask you to stop drinking for a certain period of time. After that, the doctor will take blood and urine samples.

The doctor will also measure a number of things, such as:

• Blood sodium.
• Blood osmolality.
• ADH in the blood.
• Urine composition.
• urine output.
• Weight.

Not only measuring ADH levels, doctors may also give synthetic ADH during the test. This is done to see the response of the kidneys.

3. Magnetic Resonance Imaging (MRI)

An MRI examination can be done to identify whether there is damage to the brain tissue.

Apart from that, the doctor can also see an overview of the pituitary gland or hypothalamus to find out possible damage or abnormalities.

4. Genetic Screening

This test is done to find out the type of diabetes insipidus that is passed down in families.

Also Read: The Link Between Diabetes and Body Cholesterol Levels

Types of Diabetes Insipidus

Type diabetes has 4 types, including:

1. Central Diabetes Insipidus

This type of diabetes insipidus is the most common. The cause is damage to the pituitary gland or hypothalamus.

The damage means that antidiuretic hormone cannot be produced, stored, or released as it should. This condition eventually causes a large amount of fluid to be excreted by the body through urine.

There are several conditions that trigger central diabetes insipidus, including:

• Head trauma.
• Brain tumor.
• Conditions that cause swelling in the brain.
• Surgery affecting the pituitary gland or hypothalamus.
• A rare genetic condition.

2. Nephrogenic Diabetes Insipidus

This type of diabetes is inherited through genetics. The existence of certain genetic mutations can cause the kidneys to be damaged so that they cannot respond properly to antidiuretic hormone.

Some possible triggers for this condition include:

• Certain drugs, such as lithium or tetracycline (achromycin V).
• Chronic kidney disease.
• Blockage in the urinary tract.
• Electrolyte imbalance.

3. Gestational Diabetes Insipidus

Gestational diabetes insipidus occurs when an enzyme produced by the placenta destroys the antidiuretic hormone in the body.

Conditions can also occur when the body produces more prostaglandins than usual. Prostaglandins are chemicals that are similar to hormones in the body. If there is excessive production, the kidneys become less sensitive to antidiuretic hormone.

This condition can happen to pregnant women and will heal after pregnancy.

4. Dipsogenic Diabetes Insipidus

Dipsogenic diabetes insipidus, also known as primary polydipsia, occurs when there is damage to the body’s mechanisms that regulate thirst.

As a result, a person may feel excessively thirsty and drink too much fluid.

Too much fluid entering the body can suppress vasopressin secretion. This condition causes frequent urination.

Dipsogenic diabetes insipidus is often associated with drug use and certain conditions, including mental disorders.

Treatment of Diabetes Insipidus

Basically, the treatment for this condition varies depending on the type of diabetes you have. Some of the common treatments include:

1. Central Diabetes Insipidus

In general, the treatment of this type of diabetes is desmopressin, an artificial hormone which is a synthetic form of ADH.

Desmopressin is available as a nasal spray, pill, and injection.

While using this medicine, pay attention again to the amount of fluid intake into the body and only drink when you feel thirsty.

2. Nephrogenic Diabetes Insipidus

Handling for this type of diabetes can be done by addressing the cause first.

In general, several drugs for nephrogenic diabetes insipidus that may be prescribed include:

• High dose desmopressin.
• Diuretics that are safe to take with aspirin or ibuprofen.
• Non-steroidal anti-inflammatory drugs (NSAIDs).

It’s important to remember, when taking these types of drugs, drinking water should only be done when you feel thirsty.

If the trigger for diabetes you are experiencing is a certain type of drug, the doctor will usually replace or stop using the drug.

For the record, avoid reducing the dosage of the drug or stopping its use without consulting a doctor first.

3. Gestational Diabetes Insipidus

Generally, this type of diabetes does not require special treatment. However, in severe cases, a doctor may prescribe desmopressin.

4. Dipsogenic Diabetes Insipidus

There is no specific treatment that can treat this type of diabetes. However, some well managed symptoms can help.

Also Read: Physical Changes That Can Occur When Someone Has Diabetes

Diabetes Insipidus Complications

Some of the complications that can occur from this condition include:

1. Dehydration

Fluid that comes out too much from the body can cause dehydration. As a result, you can experience several conditions such as:

• Dry mouth.
• thirst.
• Fatigue.
• Reduced skin elasticity.

2. Electrolyte Imbalance

Diabetes insipidus can cause an imbalance of minerals in the blood, such as potassium and sodium. In fact, both are important for maintaining fluid balance in the body.

Some of the symptoms that can appear:

• Nauseous.
• Vomit.
• Loss of appetite.
• Confusion.
• Weakness.
• Muscle cramp.

This is an explanation of diabetes insipidus, from symptoms to treatment. If you experience some of the symptoms mentioned above, don’t delay getting your condition checked by a doctor.

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