Diabetes Insipidus (DI)

What is Diabetes Insipidus (DI)

Diabetes insipidus is a rare condition that causes the body to produce more urine than normal.

This leads to thirst and dehydration. In this condition, the urine is made mostly of water (dilute urine). DI affects mostly adults, but it can happen at any age.

There are four types of DI:

  • Central DI. This is the most common type.
  • Dipsogenic DI.
  • Nephrogenic DI.
  • Gestational DI.

The most common forms of this condition are caused by a decrease in the production of the hormone that regulates urine output (antidiuretic hormone), or the body’s resistance to this hormone.

This condition is not related to type 1 or type 2 diabetes mellitus. These two types of diabetes cause blood sugar (glucose) levels to become too high.

What are the causes?

Central DI is caused by damage to the pituitary gland or hypothalamus in the brain. Dipsogenic DI is caused by a defect in the thirst mechanism in the brain. This defect causes you to drink too much fluid. These may result from:

  • Brain surgery.
  • Infection.
  • Inflammation.
  • Brain tumor.
  • Head injury.

Nephrogenic DI is caused by the kidneys not responding to the antidiuretic hormone in the body. This may result from:

  • Chronic kidney disease (CKD).
  • Certain medicines, such as lithium.
  • Low potassium levels.
  • High calcium levels.

Gestational DI is rare and is caused by the antidiuretic hormone that has stopped working properly.

What are the signs or symptoms?

Symptoms of this condition include:

  • Excessive urination. This means urinating more than 10 cups (2.4 L) during a period of 24 hours.
  • Excessive thirst.
  • Frequent nighttime urination (nocturia).
  • Nausea.
  • Diarrhea.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your medical history.
  • A physical exam.
  • Blood tests.
  • Urine tests.
  • A water deprivation test. During this test, you will stop drinking fluids for a period of time and your blood and urine will be checked regularly.
  • An MRI.

How is this treated?

Once your specific type of diabetes insipidus is diagnosed, treatment may include one or more of the following:

  • Increasing or limiting your fluid intake.
  • Taking medicines that contain artificial (synthetic) versions of the antidiuretic hormone.
  • Stopping certain medicines that you take.
  • Correcting the balance of minerals (electrolytes) in your body.
  • Changing your diet. You may be put on a low-protein or low-sodium diet.

You may need to visit your health care provider regularly to make sure your condition is being treated properly. You may also need to work with providers who specialize in:

  • Kidney problems (nephrologist).
  • Hormone disorders (endocrinologist).

Follow these instructions at home:

  • Follow instructions from your health care provider about how much fluid and water to drink. You may be directed to drink more fluids and water, or to limit how much fluid and water you drink.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • If directed, monitor your risk of dehydration in extreme heat.
  • Keep all follow-up visits as told by your health care provider. This is important.

Carry a medical alert card or wear medical alert jewelry.

Contact a health care provider if:

  • You continue to have symptoms after treatment.

Get help right away if:

  • You have extreme thirst.
  • You have symptoms of severe dehydration, such as rapid heart rate, muscle cramps, or confusion.

Summary

  • Diabetes insipidus (DI) is a rare condition that causes the body to produce more urine than normal, which leads to thirst and dehydration.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Treatment may include increasing or limiting your fluid intake and correcting the balance of minerals (electrolytes) in your body.
  • Get help right away if you have symptoms of severe dehydration, such as rapid heart rate, muscle cramps, or confusion.
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