Diabetes insipidus is a medical condition in which the kidneys are unable to retain water in the body, and this happens when there’s an Antidiuretic Hormone (ADH) deficiency. The hormone helps the body retain water, and changes in its level can affect the body adversely. To learn more about what is diabetes insipidus, you should first be aware of its types.
There are two types of diabetes insipidus:
- Central Diabetes Insipidus
- Nephrogenic Diabetes Insipidus
Sometimes, the condition may also result due to the use of drugs like Lithium and Amphotericin B. It affects adults as well as children.
What Is Diabetes Insipidus Caused By?
Central Diabetes Insipidus
Central diabetes insipidus can be caused by damage to the hypothalamus or pituitary gland as a result of:
- Brain tumors
- Head trauma
- Post surgical damage of brain or associated structures
- Decrease in size of pituitary gland due to auto antibodies
- Genetic transmission
The exact cause is not known in 30-50% of people who are affected by central diabetes insipidus.
Nephrogenic Diabetes Insipidus
This type of diabetes insipidus results when the kidneys do not function properly in response to the antidiuretic hormone. This can occur due to electrolyte imbalance, medications, systemic processes, and even kidney disease.
- Medications like lithium, amphotericin, gentamicin and loop diuretics can cause diabetes insipidus. Lithium accumulates in the collecting tubule cells, interfering with several water/urea channels and impairing urinary concentrating ability.
- An imbalance of electrolytes like hypercalcemia and hypokalemia can cause diabetes insipidus.
- Kidney related conditions like obstructive uropathy, chronic kidney disease, post-kidney transplant measures, and infections can cause the disease.
- Systemic processes like sarcoid, amyloid, multiple myeloma, sickle cell disease, and pregnancy can cause diabetes insipidus.
The Symptoms Of Diabetes Insipidus
Once you’ve understood what is diabetes insipidus and how it’s caused, you should be aware of the symptoms of the disease, in order to spot it properly. The main symptoms are:
- Polyuria (Excessive urination)
- Polydipsia (Excessive thirst, in spite of consuming large quantities of water)
- Disturbed sleep pattern
- Fatigue
Tests For Diagnosing Diabetes Insipidus
The estimation of urinary electrolytes like sodium, chloride, and calcium can help in diagnosing the condition. Serum osmolality is measured along with the specific gravity for this purpose.
The rate at which the patient urinates over 24 hours is also noted, as the volume of urine will be significantly more in individuals with diabetes insipidus. The glucose levels in blood and urine are also measured to confirm the condition.
Treatment Measures For Diabetes Insipidus
The treatment measures can be divided mainly into two parts: general measures and hormonal therapy.
General Measures
There are two aims that general diabetes insipidus treatment measures seek to fulfil.
- Maintaining hydration
- Maintaining body weight
This can be done through the proper intake of fluids and by choosing the right diet, with all the essential nutrients, which will help the body retain its weight.
Hormonal Therapy
If you’ve correctly understood what is diabetes insipidus, you’ll remember that it’s caused by a hormonal deficiency. There are medicines that can help in generating this hormone, and these can be used for hormonal therapy.
The medication used to treat this disorder is called Desmopressin Acetate (DDAVP), and this is similar to ADH. It is usually administered through injections or nasal sprays.
Other medications like Terlipressin, Lypressin, and Felypressin are similar to DDAVP and can be used too.
Drugs like chlorpropamide, carbamazepine, and clofibrate help the body churn out more ADH, and these are used in some cases. Doctors might also prescribe medication that helps your body retain salt, as this can in turn help the body retain water.
By understanding what is diabetes insipidus, you can watch out for the symptoms and stay informed so that immediate treatment measures can be taken in case the disease surfaces.