What are the types of diabetes insipidus? Central Diabetes Insipidus The most common form of serious diabetes insipidus, central diabetes insipidus, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. Damage to the pituitary gland can be caused by different diseases as well as by head injuries, neurosurgery, or genetic disorders. To treat the ADH deficiency that results from any kind of damage to the hypothalamus or pituitary, a synthetic hormone called desmopressin can be taken by an injection, a nasal spray, or a pill. While taking desmopressin, a person should drink fluids only when thirsty and not at other times. The drug prevents water excretion, and water can build up now that the kidneys are making less urine and are less responsive to changes in body fluids. Nephrogenic Diabetes Insipidus Nephrogenic diabetes insipidus results when the kidneys are unable to respond to ADH. The kidneys' ability to respond to ADH can be impaired by drugs-like lithium, for example-and by chronic disorders including polycystic kidney disease, sickle cell disease, kidney failure, partial blockage of the ureters, and inherited genetic disorders. Sometimes the cause of nephrogenic diabetes insipidus is never discovered. Desmopressin will not work for this form of diabetes insipidus. Instead, a person with nephrogenic diabetes insipidus may be given hydrochlorothiazide (HCTZ) or indomethacin. HCTZ is sometimes combined with another drug called amiloride. The combination of HCTZ and amiloride is sold under the brand name Moduretic. Again, with this combination of drugs, one should drink fluids only when thirsty and not at other times. Dipsogenic Diabetes insipidus Dipsogenic diabetes insipidus is caused by a defect in or damage to the thirst Continue reading >>
Overview Diabetes insipidus is a rare condition where you produce a large amount of urine and often feel thirsty. Diabetes insipidus isn't related to diabetes mellitus (usually just known as diabetes), but it does share some of the same signs and symptoms. The two main symptoms of diabetes insipidus are: passing large amounts of urine, even at night (polyuria) In very severe cases of diabetes insipidus, up to 20 litres of urine can be passed in a day. Read more about the symptoms of diabetes insipidus. When to seek medical advice You should always see your GP if you're feeling thirsty all the time. Although it may not be diabetes insipidus, it should be investigated. Also see your GP if you're: passing more urine than normal – most healthy adults pass urine four to seven times in a 24 hour period passing small amounts of urine at frequent intervals – sometimes, this can occur along with the feeling that you need to pass urine immediately Children tend to urinate more frequently because they have smaller bladders. However, seek medical advice if your child urinates more than 10 times a day. Your GP will be able to carry out a number of tests to help determine what's causing the problem. Read more about diagnosing diabetes insipidus. What causes diabetes insipidus? Diabetes insipidus is caused by problems with a hormone called vasopressin (AVP), also called antidiuretic hormone (ADH). AVP plays a key role in regulating the amount of fluid in the body. It's produced by specialist nerve cells in a part of the brain known as the hypothalamus. AVP passes from the hypothalamus to the pituitary gland where it's stored until needed. The pituitary gland releases AVP when the amount of water in the body becomes too low. It helps retain water in the body by reducing the amount Continue reading >>
What Is Diabetes Insipidus?
Most people have heard of the two main types of diabetes. But did you know the name has nothing to do with high blood sugar? It's a general term for any condition that causes your body to make a lot of urine. And that’s just what, diabetes insipidus does. This condition makes you extra thirsty. As a result, you pee -- a lot. Your body makes a substance called antidiuretic hormone (ADH). It’s produced in a part of your brain called the hypothalamus and stored in your pituitary gland. It tells your kidneys to hold onto water, which makes your urine more concentrated. When you’re thirsty or slightly dehydrated, ADH levels rise. Your kidneys reabsorb more water and put out concentrated urine. If you’ve had plenty to drink, ADH levels fall and what comes out is clear and dilute. When your body doesn’t make enough ADH, the condition is called central diabetes insipidus. If you make enough but your kidneys can't respond to it, you have nephrogenic diabetes insipidus. In either form, the result is the same. Your kidneys can't retain water, so even if you’re dehydrated, they'll put out a lot of pale, or diluted urine. When your kidneys can’t conserve water, you’ll: Get really thirsty Pee a lot -- this is known as polyuria Some people get dehydrated. If you lose too much water, you could have: Lethargy Muscle pains Irritability If you have this condition, you’ll probably wind up at the doctor for help with your thirst and constant need for a bathroom. To diagnose you, the doctor will do a series of blood and urine tests that may take several hours. You’ll go without water the whole time, so you’ll get thirstier. Your doctor will measure the sodium in your blood and pee. He may give you an ADH substitute to see if your kidneys respond by concentrating your ur Continue reading >>
Central Diabetes Insipidus
In CDI, symptoms may develop over time or abruptly and may affect individuals of any age. CDI is characterized by excessive thirst (polydipsia) and excessive urination (polyuria), even at night (nocturia). The severity and progression of CDI varies from case to case. Some individuals may have a severe form of the disorder (complete CDI) with little or no vasopressin activity. Others may have a mild form of the disorder (partial CDI) with residual vasopressin activity. Without appropriate AVP secretion, individuals with central diabetes insipidus are unable to concentrate the urine by reabsorbing water in the kidneys. This results in obligatory excessive urine output of dilute urine. Consequently, individuals must drink excessively to prevent dehydration. In response to thirst, affected individuals may drink several gallons of water a day. If affected individuals are deprived of water for an extended period of time, rapid dehydration will occur. Thirst cravings can be strong enough to awaken people from sleep. In infants, additional symptoms may occur including irritability, lethargy, vomiting, constipation and fever. If left untreated, repeated episodes of dehydration can potentially result in seizures, brain damage, developmental delays, and physical and mental retardation. However, with proper diagnosis and prompt treatment intelligence and development is usually normal unless more global problems in development of the brain are associated. Affected children may develop bedwetting (enuresis), fatigue, weight loss, and growth retardation. Individuals with CDI are at risk of developing dehydration and cardiovascular symptoms including irregular heartbeats, fever, dry skin and mucous membranes, confusion, seizures, change in consciousness, and potentially coma. Affected Continue reading >>
What Is Diabetes Insipidus?
Diabetes insipidus is a condition that results from insufficient production of the antidiuretic hormone (ADH), a hormone that helps the kidneys and body conserve the correct amount of water. Normally, the antidiuretic hormone controls the kidneys' output of urine. It is secreted by the hypothalamus (a small gland located at the base of the brain), stored in the pituitary gland, and then released into the bloodstream. ADH is secreted to decrease the amount of urine output so that dehydration does not occur. Diabetes insipidus, however, causes excessive production of very diluted urine and excessive thirst. The disease is categorized into groups: Central diabetes insipidus. An insufficient production or secretion of ADH; can be a result of damage to the hypothalamus or pituitary gland caused by head injuries, genetic disorders, and other diseases. Nephrogenic diabetes insipidus. A lack of kidney response to normal levels of ADH: can be caused by drugs or chronic disorders, such as kidney failure, sickle cell disease, or polycystic kidney disease. What causes diabetes insipidus? Diabetes insipidus can be caused by several conditions, including the following: Malfunctioning hypothalamus (that produces too little ADH) Malfunctioning pituitary gland (that fails to release ADH into the bloodstream) Damage to hypothalamus or pituitary gland during surgery Brain injury Tumor Blockage in the arteries leading to the brain Encephalitis (inflammation of the brain) Meningitis (inflammation of the meninges, the membranes that cover the brain and spinal cord) Sarcoidosis (a rare inflammation of the lymph nodes and other tissues throughout the body) Family heredity What are the symptoms of diabetes insipidus? The following are the most common symptoms of diabetes insipidus. However, eac Continue reading >>
What Is Diabetes Insipidus?
Diabetes Insipidus What is diabetes insipidus (DI) and why do we get it? Diabetes insipidus (DI) is caused by a problem with either the production, or action, of the hormone vasopressin (AVP). If you have DI your kidneys are unable to retain water. This leads to the production of large volumes of urine and, in turn, greatly increased thirst. DI can occur at any age, but is mostly found in adults. It is a rare disorder, affecting only about 1 in 25,000 people. To understand DI we need to understand a little about how the body regulates water balance - the difference between how much water the body takes in and how much it passes out. Water balance is very important for the body. A large proportion of what we are is made up of water. In addition, the amount of water we have in our circulation is a large factor in determining the balance of salt in our bodies. As with any function that is important, the body has a sensitive mechanism for regulating water balance. Like any good mechanism it is also simple, involving two key components: • Vasopressin (AVP or ADH - antidiuretic hormone) - which regulates the amount of water passed out of the body in urine. • Thirst and drinking - which determines the amount of water the body takes in. AVP (sometimes called Anti-diuretic hormone or ADH) is a hormone released from the rear most part of the pituitary gland (the posterior pituitary). This gland is located at the base of the brain, and is about 3 to 5 centimetres behind the bridge of the nose. AVP circulates in the bloodstream and acts on the kidneys to reduce the amount of water that is passed out in urine. How AVP and thirst work together is best described with the help of the bath tub analogy. As with a bath tub, the body likes to keep the level of water it contains at the Continue reading >>
Print Overview Diabetes insipidus (die-uh-BEE-teze in-SIP-uh-dus) is an uncommon disorder that causes an imbalance of water in the body. This imbalance leads to intense thirst even after drinking fluids (polydipsia), and excretion of large amounts of urine (polyuria). While the names diabetes insipidus and diabetes mellitus sound similar, they're not related. Diabetes mellitus — which can occur as type 1 or type 2 — is the more common form of diabetes. There's no cure for diabetes insipidus, but treatments are available to relieve your thirst and normalize your urine output. Symptoms The most common signs and symptoms of diabetes insipidus are: Extreme thirst Excretion of an excessive amount of diluted urine Depending on the severity of the condition, urine output can be as much as 16 quarts (about 15 liters) a day if you're drinking a lot of fluids. Normally, a healthy adult will urinate an average of less than 3 quarts (about 3 liters) a day. Other signs may include needing to get up at night to urinate (nocturia) and bed-wetting. Infants and young children who have diabetes insipidus may have the following signs and symptoms: Unexplained fussiness or inconsolable crying Trouble sleeping Fever Vomiting Diarrhea Delayed growth Weight loss When to see a doctor See your doctor immediately if you notice the two most common signs of diabetes insipidus: excessive urination and extreme thirst. Causes Diabetes insipidus occurs when your body can't regulate how it handles fluids. Normally, your kidneys remove excess body fluids from your bloodstream. This fluid waste is temporarily stored in your bladder as urine, before you urinate. When your fluid regulation system is working properly, your kidneys conserve fluid and make less urine when your body water is decreased, suc Continue reading >>
Symptoms The most common symptoms associated with diabetes insipidus (DI) are extreme thirst and excessive urination. Some patients may drink as much as a full glass of fluids every 10 to 20 minutes. As DI may start in the toddler age group, the excessive thirst and asking for fluids may be misinterpreted as “bad behavior” or habit and parents may be mistakenly told to withhold fluids to break the habit. It is important that these children are allowed open access to fluids until treatment is started. If unable to find fluids easily, some children have been known to drink directly from faucets, baths, pet dishes, swimming pools, and other unusual sources around the home. The extreme urination may continue throughout the day and the night, sometimes as often as every 15-20 minutes, and often includes bed-wetting. The urine is usually pale, without color. Symptoms of diabetes insipidus are very similar to those of diabetes mellitus, except that the urine does not contain high sugar levels. Diabetes insipidus can interfere with appetite and eating. In children, it can interfere with growth and weight gain. Signs of dehydration often appear, since the body is unable to keep enough of the water it takes in. Symptoms of dehydration include: Dry skin Dry mucous membranes (sticky mouth) /reduced tears Sunken appearance to eyes Sunken fontanelles (soft spot in the skull) in infants Fatigue/sleepiness Weight loss Headache Irritability Low body temperature Muscle pains Rapid heart rate Low blood pressure/shock Adults with untreated DI may be able to drink enough water to make up for the extreme loss of urine. However, there is a serious risk of dehydration and imbalances in the blood, such as salt and potassium. Most patients with diabetes insipidus have an abnormal appearance Continue reading >>
The two main symptoms of diabetes insipidus are often needing to pass large amounts of urine and feeling extremely thirsty. If you have diabetes insipidus, you may pass pale, watery urine every 15-20 minutes. The amount of urine passed can range from 3 litres (5.2 pints) in mild cases to up to 20 litres (35 pints) in severe cases. It's also likely that you'll feel thirsty all the time and have a 'dry' feeling that's always present, no matter how much water you drink. If you need to pass urine regularly and always feel thirsty, your sleeping patterns and daily activities may be disrupted. This can cause tiredness, irritability and difficulty concentrating, which can affect your daily life further. You may also feel generally unwell and 'run down' much of the time for no apparent reason. Symptoms in children Excessive thirst can be difficult to recognise in children who are too young to speak. Signs and symptoms that could suggest diabetes insipidus include: excessive crying irritability slower than expected growth hyperthermia (high body temperature) In older children, symptoms of diabetes insipidus include: wetting the bed (enuresis) – although most children who wet the bed don't have diabetes insipidus loss of appetite feeling tired all the time (fatigue) Next review due: 01/04/2019 Continue reading >>
Nephrogenic Diabetes Insipidus
NORD gratefully acknowledges Jeff M. Sands, MD, Juha P. Kokko Professor of Medicine and Physiology, Renal Division Director, Executive Vice-Chair of Medicine, Emory University School of Medicine, for assistance in the preparation of this report. Synonyms of Nephrogenic Diabetes Insipidus acquired nephrogenic diabetes insipidus congenital nephrogenic diabetes insipidus hereditary nephrogenic diabetes insipidus NDI vasopressin-resistant diabetes insipidus General Discussion Summary Nephrogenic diabetes insipidus (NDI) is a rare kidney disorder that may be inherited or acquired. NDI is not related to the more common diabetes mellitus (sugar diabetes), in which the body does not produce or properly use insulin. NDI is a distinct disorder caused by complete or partial resistance of the kidneys to arginine vasopressin (AVP). Vasopressin is an antidiuretic hormone used by the kidney to manage water balance in the body. NDI causes chronic excessive thirst (polydipsia), excessive urine production (polyuria), and potentially dehydration. If left untreated, repeated episodes of severe dehydration may develop, eventually resulting in serious complications. Most cases of hereditary NDI are inherited as X-linked recessive disorders. Rare cases are inherited as an autosomal recessive or dominant disorder. Two different genes have been identified that cause hereditary NDI. NDI may also be acquired during life as a result of drug use (e.g., lithium therapy), kidney disease, obstruction of the tubes that carry urine from the kidneys to the bladder (ureters), and prolonged metabolic imbalances such as low levels of potassium in the blood (hypokalemia) or high levels of calcium in the blood (hypercalcemia). NDI may also be a temporary complication associated with pregnancy. Introduction Th Continue reading >>
On this page: What is diabetes insipidus? Diabetes insipidus is a rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine that is insipid—dilute and odorless. In most people, the kidneys pass about 1 to 2 quarts of urine a day. In people with diabetes insipidus, the kidneys can pass 3 to 20 quarts of urine a day. As a result, a person with diabetes insipidus may feel the need to drink large amounts of liquids. Diabetes insipidus and diabetes mellitus—which includes both type 1 and type 2 diabetes—are unrelated, although both conditions cause frequent urination and constant thirst. Diabetes mellitus causes high blood glucose, or blood sugar, resulting from the body's inability to use blood glucose for energy. People with diabetes insipidus have normal blood glucose levels; however, their kidneys cannot balance fluid in the body. What are the kidneys and what do they do? The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys normally filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. How is fluid regulated in the body? A person's body regulates fluid by balancing liquid intake and removing extra fluid. Thirst usually controls a person’s rate of liquid intake, while urination removes most fluid, although people also lose fluid through sweating, breathing, or diarrhea. The hormone vasopressin, also called antidiuretic hormone, con Continue reading >>
Everything You Should Know About Diabetes Insipidus
What is diabetes insipidus? Diabetes insipidus (DI) is a rare condition that occurs when your kidneys are not able to conserve water. DI is not related to diabetes mellitus, which is often referred to simply as diabetes. That means you can have DI without having diabetes. In fact, the condition can occur in anyone. DI results in extreme thirst and frequent urination of dilute and odorless urine. There are several types of DI, and they can often be successfully treated. Keep reading to learn more about this condition. The main symptoms of DI are excessive thirst, which can cause an uncontrollable craving for water, and excessive urine volume. A healthy adult will typically urinate less than 3 quarts of urine a day. People with DI may eliminate up to 16 quarts of urine a day. You may need to get up during the night to urinate frequently, or you may experience bed-wetting. Possible symptoms in young children and infants include: fussiness and irritability unusually wet diapers or bed-wetting, or excessive urine output excessive thirst dehydration high fever dry skin delayed growth Adults can experience some of the above symptoms, plus confusion, dizziness, or sluggishness. DI can also lead to severe dehydration, which can lead to seizures, brain damage, and even death if not treated. You should contact your doctor immediately if you or your child is experiencing these symptoms. To understand diabetes insipidus, it helps to understand how your body normally uses and regulates fluids. Fluids make up as much as 60 percent of your overall body mass. Maintaining the proper amount of fluid in your body is key to your overall health. Consuming water and food throughout the day helps provide fluid to your body. Urinating, breathing, and sweating help to eliminate fluid from your b Continue reading >>
During the day, your kidneys filter all your blood many times. Normally, most of the water is reabsorbed, and only a small amount of concentrated urine is excreted. DI occurs when the kidneys cannot concentrate the urine normally, and a large amount of dilute urine is excreted. The amount of water excreted in the urine is controlled by antidiuretic hormone (ADH). ADH is also called vasopressin. ADH is produced in a part of the brain called the hypothalamus. It is then stored and released from the pituitary gland. This is a small gland just below the base of the brain. DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. Nephrogenic means related to the kidney. Central DI can be caused by damage to the hypothalamus or pituitary gland as a result of: Head injury Infection Loss of blood supply to the pituitary gland Surgery Nephrogenic DI involves a defect in the kidneys. As a result, the kidneys do not respond to ADH. Like central DI, nephrogenic DI is very rare. Nephrogenic DI may be caused by: Certain drugs, such as lithium Genetic problems Continue reading >>
Diabetes insipidus is characterised by extreme thirst and the passing of large amounts of urine. It is caused by the lack of sufficient vasopressin, a hormone produced by the brain that instructs the kidneys to retain water. Treatment options include vasopressin replacement. On this page: Diabetes insipidus is characterised by extreme thirst and the passing of vast amounts of urine. It is caused by insufficient vasopressin, a hormone produced by the brain that instructs the kidneys to retain water. Without enough vasopressin, too much water is lost from the body in urine, which prompts the affected person to drink large amounts of fluids in an attempt to maintain their fluid levels. In severe cases, a person may pass up to 30 litres of urine per day. Without treatment, diabetes insipidus can cause dehydration and, eventually, coma due to concentration of salts in the blood, particularly sodium. The name of this condition is a little misleading, since diabetes insipidus has nothing to do with diabetes mellitus (a condition characterised by high blood sugar levels), apart from the symptoms of thirst and passing large volumes of urine. The word diabetes means 'to go through' - describing the excessive urination. Insipidus means the urine is tasteless, whereas mellitus suggests it is sweet from its sugar content. This terminology dates back to a time when physicians literally dipped a finger in the patient's urine and tested its taste. Not a diagnostic method much in use today! Symptoms The symptoms of diabetes insipidus include: Extreme thirst that can't be quenched (polydipsia) Excessive amounts of urine (polyuria) Colourless urine instead of pale yellow Waking frequently through the night to urinate Dry skin Constipation Weak muscles Bedwetting. Too much water is lost in Continue reading >>
Central Diabetes Insipidus
(Vasopressin-Sensitive Diabetes Insipidus) By Ian M. Chapman, MBBS, PhD, Professor of Medicine, Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital Central diabetes insipidus is a lack of the hormone vasopressin (antidiuretic hormone) that causes excessive production of very dilute urine (polyuria). Central diabetes insipidus has several causes, including a brain tumor, a brain injury, brain surgery, tuberculosis, and some forms of other diseases. The diagnosis is based on urine tests, blood tests, and a water deprivation test. Vasopressin is a hormone produced by the hypothalamus (a region of the brain that lies just above the pituitary) and stored in and released from the posterior lobe of the pituitary gland. Vasopressin helps regulate the amount of water in the body by signalling the kidneys to decrease the amount of urine they produce (see About Body Water). Because a diuretic is a substance that increases urine production, vasopressin previously was referred to as antidiuretic hormone. Causes Other disorders that can cause central diabetes insipidus include accidental damage done during surgery on the hypothalamus or pituitary gland; a brain injury, particularly a fracture of the base of the skull; a tumor; sarcoidosis or tuberculosis; an aneurysm (a bulge in the wall of an artery) or blockage in the arteries leading to the brain; some forms of encephalitis or meningitis; and the rare disease Langerhans cell histiocytosis. Nephrogenic diabetes insipidus is another type of diabetes insipidus in which there is an adequate amount of vasopressin, but abnormalities in the kidneys cause them not to respond to vasopressin. Symptoms Diagnosis Doctors suspect diabetes insipidus in people who produce large amounts of urine. They first test the urine for Continue reading >>