Diabetes Insipidus is a disorder in which the person produces a lot of dilute or light-colored urine even when he/she is not hydrated sufficiently. While a healthy adult produces around 2.84 liters of urine per day, an adult with Diabetes Insipidus (DI) will output as much as 19 liters of urine per day. Compared to other ailments, this is quite rare, affecting 1 in 25000 people. If ignored or left untreated, it can cause various complications over time. So it’s important to recognize the symptoms and seek timely medical help.
Diabetes Insipidus is often confused with Diabetes Mellitus because both of them cause thirst, frequent urination and more intake of fluids. However, the similarity ends there.
As much as 60 percent of the adult human body comprises of fluids, including water. Routines such as breathing, urinating and sweating help remove excess fluids from the body, while consuming food, beverages and water increases fluid content in the body. It is important to ensure proper fluid balance in the body for good physical and mental health. This is achieved through certain organs and hormones in the body.
The above process happens constantly, on a daily basis. But in people with DI, there is an irregularity in the process, making the person produce a lot of dilute urine whether he/she is sufficiently hydrated or not. This leads to dehydration, electrolyte imbalance, etc.
DI is of 4 broad types, each with its unique causes and pathology.
This is the most common type. In this, there is damage to either the pituitary or the hypothalamus or both. As a result, the mechanism for producing, storing and releasing ADH is impaired. In the process, the kidneys produce copious amounts of urine. The possible causes for this damage are:
As the name implies, there is damage to the kidneys, and one of the consequences is DI. Possible causes include:
In this type, the hypothalamus is not damaged, but its ability to regulate thirst is impaired. So the person feels thirsty all the time, consumes a lot of fluids and hence produces a lot of urine. Causes for this include:
As the name implies, this type occurs only during the term of pregnancy and disappears gradually after childbirth. The placenta is an organ that develops in the uterus during pregnancy. It is responsible for delivering nutrition to the fetus and removing wastes from the baby’s blood. To achieve these functions, the placenta secretes several hormones which sometimes can alter other body functions. So prominent causes of Gestational DI include:
One or more of the below tests are undertaken to confirm or rule out DI.
If the abnormality in the hypothalamus or pituitary is caused by a tumor or other reason, then that condition is resolved first. After that, a synthetic version of vasopressin called desmopressin is given as an injection or nasal spray. This takes over the function of natural ADH and decreases urination. The dosage of desmopressin will depend on the extent of Central DI. Also, to increase the availability of this synthetic vasopressin in the body, other drugs such as chlorpropamide may be given.
Since this type involves some impairment in the kidneys, measures are taken to address that.
There is no specific treatment for this condition. However, if a mental health condition is causing the ailment, treating the same will relieve the symptoms of this condition.
Since this condition is temporary, treatment is not required for every patient. However, some women may be given Desmopressin which is safe for both mother and child.
Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals
NOTE: Take medications only when prescribed by your doctors, self-medication must be avoided under any circumstances.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem and Bengaluru, the hospital also renders adult and pediatric trauma care.
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