Diabetes insipidus is a hormonal metabolic disorder in which the affected individual cannot regulate the water balance inside the body due to this other salt level are imbalanced which further leads to other disorders.
Diabetes insipidus is not to be confused with diabetes mellitus (both type 1 and 2), these both are completely different, even though they have one common symptoms which is Polyuria. So it’s necessary to get diagnosed and consulted by a doctor before coming to a conclusion.
Diabetes insipidus is rare in population unlike mellitus. It is caused due to imbalance production of antidiuretic hormone (ADH) in pituitary gland or defect in kidneys response to antidiuretic hormone (ADH).
Based upon the cause diabetes insipidus is of 2 types
- Neurogenic:Neurogenic diabetes insipidus, more commonly known as central diabetes insipidus, is due to the lack of vasopressin production in the hypothalamus due to a range of causes. The underlying causes of Central diabetes insipidus I can include vascular, autoimmune, infection, some drugs, surgery, and head trauma, benign or metastatic pituitary-hypothalamic tumor.
- Nephrogenic:Nephrogenic diabetes insipidus is due to the inability of the kidney to respond normally to vasopressin.
- Gestational:Gestational diabetes insipidus occurs only during pregnancy and the postpartum period. During pregnancy, women produce vasopressinase in the placenta, which breaks down ADH. Gestational Diabetes insipidus is thought to occur with excessive production and/or impaired clearance of vasopressinase
Signs and symptoms
- Excessive urination
- Extreme thirst especially for cold water
- Dehydration caused due excessive loss of urine in the form of dilutes urine
- Interference in appetite, growth and weight
Urine and blood analysis for electrolytes
Fluid deprivation test helps in distinguishing between neurogenic and nephrogenic
Neurogenic and Gestational diabetes insipidus
Central and gestational diabetes insipidus respond to desmopressin which is given as intranasal or oral tablets.
Carbamazepine, an anticonvulsive medication, has also had some success in this type of Diabetes insipidus.
Nephrogenic Diabetes insipidus
Desmopressin will be ineffective in nephrogenic diabetes insipidus and is treated by reversing the underlying cause (if possible) and replacing the free water deficit.
The diuretic hydrochlorothiazide (a thiazide diuretic) or indomethacin can be used to create mild hypovolemia which encourages salt and water uptake in proximal tubule and thus improve nephrogenic diabetes insipidus.
Thiazide diuretics, amiloride has recently been shown to be a successful treatment for this condition.