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Dipsogenic Diabetes Insipidus Treatment

Dipsogenic Diabetes Insipidus

Dipsogenic Diabetes Insipidus

Dipsogenic diabetes insipidus is similar to other manifestations of this disorder, especially in regards to neurogenic versions. It causes extreme thirst, which creates an increased fluid intake. This creates an excessive need to urinate because of the high fluid levels. It is characterized by low levels of vasopressin within the blood plasma and high levels of plasma osmolality. Treating dipsogenic diabetes insipidus usually involves a diuretic therapy. What distinguishes this version of DI from others is that during the treatment period, the body’s need for water intake decreases less rapidly than the excretion of water from the body. Because of this, most patients who are being treated for dipsogenic diabetes insipidus will experience low sodium levels and a lack of water balance. Response to vasopressin therapy is considered to be “relatively normal,” though most patients find that the threshold for release is at the upper end of the normal scale. What Is the Primary Characteristic of Dipsogenic Diabetes Insipidus? Diabetes insipidus involves a change in hormone production, either through damage or suppression of the ability to understand water levels in the body. An illness, tumor, or surgical procedure can cause central diabetes insipidus, while a defect in the kidney tubules can cause nephrogenic diabetes insipidus. For dipsogenic diabetes insipidus, there isn’t always a physical cause that is behind the ADH suppression that occurs. This is because the underlying cause of the condition originates from a prolonged excessive intake of fluids. The consumption of excessive water or fluids on its own can damage the kidneys. When this occurs, it suppresses ADH and stops the body from being able to concentrate the urine. Many cases of dipsogenic diabetes insipid Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

What is diabetes insipidus? Diabetes insipidus occurs when your body doesn’t make enough antidiuretic hormone (ADH) or your kidneys don’t respond to it. ADH helps keep the right amount of water in your body. Normally, ADH controls how much urine your kidneys put out. This keeps you from losing too much water (being dehydrated). If you are a bit dehydrated, ADH should increase. ADH is made by the hypothalamus, a small gland at the base of the brain. It is stored in the pituitary gland and then sent into the bloodstream as needed. Diabetes insipidus is not related to the more common type of diabetes (diabetes mellitus). What is the cause of diabetes insipidus? There are several types of diabetes insipidus: Central. This type occurs when the pituitary doesn’t make or send out enough ADH. It can happen if the hypothalamus or pituitary gland are damaged. This can be caused by a head wound (including surgery on the pituitary gland,) a genetic problem, and other diseases. Nephrogenic. This type occurs when the kidneys don’t respond to normal levels of ADH. It can be caused by medicines or lifelong (chronic) disorders such as kidney disease or sickle cell disease. Dipsogenic. This type occurs when there is damage to the mechanism that controls thirst, found in the hypothalamus. As a result you are too thirsty and drink too many fluids. This slows down ADH production. Gestational. This occurs only in pregnant women. In this type, an enzyme made by the placenta destroys ADH in the mother. What are the symptoms of diabetes insipidus? Common symptoms may include: Being very thirsty Making too much urine Dehydration These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis. How is diabetes insipidus diagnosed? Your provider will Continue reading >>

Dipsogenic Diabetes Insipidus: Report Of A Novel Treatment Strategy And Literature Review

Dipsogenic Diabetes Insipidus: Report Of A Novel Treatment Strategy And Literature Review

Dipsogenic diabetes insipidus is a syndrome of disordered thirst, in patients without psychiatric disease, which may be confused with partial central diabetes insipidus. Distinguishing these entities involves monitored water testing. Therapy with antidiuretic hormone in patients with dipsogenic diabetes insipidus is thought to be contraindicated for fear of inducing water intoxication. We report a case of a 26-year-old woman without psychiatric illness referred for longstanding polyuria and polydipsia. Otherwise healthy, she complained of near-constant thirst and frequent urination, causing severe disruption of her personal and professional life. She had been consistently eunatremic and polyuric, with low urine osmolality. Results of extensive water testing revealed intact urinary concentrating and diluting capacity, physiologic though blunted antidiuretic hormone (ADH) release, and an abnormally low thirst threshold, consistent with the diagnosis of dipsogenic diabetes insipidus. To control her polyuria we initiated treatment with intermittent, low-dose, intranasal desmopressin and strict water restriction during drug dosing. In follow-up she reported excellent control of polyuria and significant functional improvement. The reviewed literature demonstrates a limited number of reports about dipsogenic diabetes insipidus, and no prior report of a similar treatment strategy. Dipsogenic diabetes insipidus is an uncommonly (and not universally) recognized disorder, requiring monitored testing in order to distinguish it from incomplete forms of central diabetes insipidus. Though therapy with desmopressin cannot be recommended based on the results of a single case, the outcome presented here is intriguing and suggests that larger studies in such patients is warranted to asses Continue reading >>

Diabetes Insipidus: Causes & Symptoms + 5 Natural Treatments

Diabetes Insipidus: Causes & Symptoms + 5 Natural Treatments

Diabetes insipidus, is a debilitating and rare disease, with a prevalence of 1 out of 25,000 people. Often referred to as “water diabetes,” it is a condition characterized by frequent and heavy urination, excessive thirst and an overall feeling of weakness. It’s caused by a defect in the pituitary gland or in the kidneys. (1) The term insipidus means “without taste” in Latin, while diabetes mellitus involves the excretion of “sweet” urine. People with diabetes insipidus pass urine that is diluted, odorless and relatively low in sodium content. Diabetes insipidus and diabetes mellitus (which includes both type 1 and type 2 diabetes) are unrelated. Both conditions do cause frequent urination and constant thirst. People with diabetes insipidus have normal blood sugar levels, but their kidneys cannot balance fluid in the body. Although the symptoms of diabetes insipidus can be bothersome and sometimes even life-changing, the condition doesn’t increase future health risks when it is managed properly. It’s important to find the right treatment plan, which typically involves taking measures to avoid dehydration. What is Diabetes Insipidus? Diabetes insipidus is a condition that disrupts normal life due to increased thirst and passing of large volumes or urine, even at night. It is a part of a group of hereditary or acquired polyuria (when large amounts of urine is produced) and polydipsia (excessive thirst) diseases. It’s associated with inadequate vasopressin or antidiuretic hormone secretion. Vasopressin, which includes arginine vasopressin (AVP) and antidiuretic hormone (ADH), is a peptide hormone formed in the hypothalamus. It then travels to the posterior pituitary where it releases into the blood. In order to fully understand the cause of diabetes ins Continue reading >>

Diabetes Insipidus: Practice Essentials, Background, Etiology

Diabetes Insipidus: Practice Essentials, Background, Etiology

Diabetes insipidus (DI) is defined as the passage of large volumes (>3 L/24 hr) of dilute urine (< 300 mOsm/kg). It has the following 2 major forms: Central (neurogenic, pituitary, or neurohypophyseal) DI, characterized by decreased secretion of antidiuretic hormone (ADH; also referred to as arginine vasopressin [AVP]) Nephrogenic DI, characterized by decreased ability to concentrate urine because of resistance to ADH action in the kidney [ 1 ] Two other forms are gestational DI and primary polydipsia (dipsogenic DI); both are caused by deficiencies in AVP, but the deficiencies do not result from a defect in the neurohypophysis or kidneys. The predominant manifestations of DI are as follows: Polyuria: The daily urine volume is relatively constant for each patient but is highly variable between patients (3-20 L) The most common form is central DI after trauma or surgery to the region of the pituitary and hypothalamus, which may exhibit 1 of the following 3 patterns: Earley LE, Orloff J. The mechanism of antidiuresis associated with the administration of hydrochlorothiazide to patients with vasopressin-resistant diabetes insipidus. J Clin Invest. Nov 1962;41(11):1988-97. Babey M, Kopp P, Robertson GL. Familial forms of diabetes insipidus: clinical and molecular characteristics. Nat Rev Endocrinol. 2011 Jul 5. 7(12):701-14. [Medline] . Bockenhauer D, van't Hoff W, Dattani M, Lehnhardt A, Subtirelu M, Hildebrandt F, et al. Secondary nephrogenic diabetes insipidus as a complication of inherited renal diseases. Nephron Physiol. 2010. 116(4):p23-9. [Medline] . Los EL, Deen PM, Robben JH. Potential of nonpeptide (ant)agonists to rescue vasopressin V2 receptor mutants for the treatment of X-linked nephrogenic diabetes insipidus. J Neuroendocrinol. 2010 May. 22(5):393-9. [Medlin Continue reading >>

Diagnosis

Diagnosis

Print Since the signs and symptoms of diabetes insipidus can be caused by other conditions, your doctor will perform a number of tests. If your doctor determines you have diabetes insipidus, he or she will need to determine which type of diabetes insipidus you have, because the treatment is different for each form of the disease. Some of the tests doctors commonly use to diagnose and determine the type of diabetes insipidus and in some cases, its cause, include: Water deprivation test. This test confirms the diagnosis and helps determine the cause of diabetes insipidus. Under medical supervision, you'll be asked to stop drinking fluids for a time so that your doctor can measure changes in your body weight, urine output and the concentration of your urine and blood when fluids are withheld. Your doctor may also measure blood levels of ADH or administer synthetic ADH during this test. The water deprivation test is performed under close supervision in children and pregnant women to make sure no more than 5 percent of body weight is lost during the test. Urinalysis. Urinalysis is the physical and chemical examination of urine. If your urine is less concentrated — meaning the amount of water is high relative to other excreted substances — it could be due to diabetes insipidus. Magnetic resonance imaging (MRI). An MRI of the head is a noninvasive procedure that uses a powerful magnetic field and radio waves to construct detailed pictures of brain tissues. Your doctor may want to perform an MRI to look for abnormalities in or near the pituitary gland. Genetic screening If your doctor suspects an inherited form of diabetes insipidus, he or she will look at your family history of polyuria and may suggest genetic screening. Treatment Treatment of diabetes insipidus depends on Continue reading >>

Dipsogenic Diabetes Insipidus: Report Of A Novel Treatment Strategy And Literature Review.

Dipsogenic Diabetes Insipidus: Report Of A Novel Treatment Strategy And Literature Review.

Abstract Dipsogenic diabetes insipidus is a syndrome of disordered thirst, in patients without psychiatric disease, which may be confused with partial central diabetes insipidus. Distinguishing these entities involves monitored water testing. Therapy with antidiuretic hormone in patients with dipsogenic diabetes insipidus is thought to be contraindicated for fear of inducing water intoxication. We report a case of a 26-year-old woman without psychiatric illness referred for longstanding polyuria and polydipsia. Otherwise healthy, she complained of near-constant thirst and frequent urination, causing severe disruption of her personal and professional life. She had been consistently eunatremic and polyuric, with low urine osmolality. Results of extensive water testing revealed intact urinary concentrating and diluting capacity, physiologic though blunted antidiuretic hormone (ADH) release, and an abnormally low thirst threshold, consistent with the diagnosis of dipsogenic diabetes insipidus. To control her polyuria we initiated treatment with intermittent, low-dose, intranasal desmopressin and strict water restriction during drug dosing. In follow-up she reported excellent control of polyuria and significant functional improvement. The reviewed literature demonstrates a limited number of reports about dipsogenic diabetes insipidus, and no prior report of a similar treatment strategy. Dipsogenic diabetes insipidus is an uncommonly (and not universally) recognized disorder, requiring monitored testing in order to distinguish it from incomplete forms of central diabetes insipidus. Though therapy with desmopressin cannot be recommended based on the results of a single case, the outcome presented here is intriguing and suggests that larger studies in such patients is warranted Continue reading >>

Diabetes Insipidus: Causes, Symptoms And Treatment

Diabetes Insipidus: Causes, Symptoms And Treatment

Diabetes insipidus is a condition where the body loses too much fluid through urination, causing a significant risk of dangerous dehydration as well as a range of illnesses and conditions. There are two forms of the disease: nephrogenic diabetes insipidus and central diabetes insipidus (also known as neurogenic diabetes insipidus). A number of factors have been linked to the development of diabetes insipidus, which may also occur in pregnancy or with the use of certain medications. Establishing the cause of the problem can help determine the most appropriate treatment to support the regulation of water balance in the body. Diabetes insipidus is a condition that can be managed successfully. Contents of this article: What is diabetes insipidus? An uncommon condition, diabetes insipidus is a disorder affecting the regulation of body fluid levels. Two key symptoms resemble those of the more common forms of diabetes that affect blood sugar levels (diabetes mellitus types 1 and 2).1-5 People with diabetes insipidus produce excessive amounts of urine (polyuria), resulting in frequent urination and, in turn, thirst (polydipsia). However, the underlying cause of these two symptoms is quite different from the causes in types 1 and 2 diabetes. In diabetes mellitus, elevated blood sugar prompts the production of large volumes of urine to help remove the excess sugar from the body. In diabetes insipidus, it is the body's water balance system itself that is not working properly. Here are some key points about diabetes insipidus. More detail and supporting information is in the body of this article. Diabetes insipidus is a condition where the body fails to properly control water balance, resulting in excessive urination. Diabetes insipidus can be caused by low or absent secretion of t Continue reading >>

Dipsogenic Diabetes Insipidus: Report Of A Novel Treatment Strategy And Literature Review.

Dipsogenic Diabetes Insipidus: Report Of A Novel Treatment Strategy And Literature Review.

Abstract: Dipsogenic diabetes insipidus is a syndrome of disordered thirst, in patients without psychiatric disease, which may be confused with partial central diabetes insipidus. Distinguishing these entities involves monitored water testing. Therapy with antidiuretic hormone in patients with dipsogenic diabetes insipidus is thought to be contraindicated for fear of inducing water intoxication. We report a case of a 26-year-old woman without psychiatric illness referred for longstanding polyuria and polydipsia. Otherwise healthy, she complained of near-constant thirst and frequent urination, causing severe disruption of her personal and professional life. She had been consistently eunatremic and polyuric, with low urine osmolality. Results of extensive water testing revealed intact urinary concentrating and diluting capacity, physiologic though blunted antidiuretic hormone (ADH) release, and an abnormally low thirst threshold, consistent with the diagnosis of dipsogenic diabetes insipidus. To control her polyuria we initiated treatment with intermittent, low-dose, intranasal desmopressin and strict water restriction during drug dosing. In follow-up she reported excellent control of polyuria and significant functional improvement. The reviewed literature demonstrates a limited number of reports about dipsogenic diabetes insipidus, and no prior report of a similar treatment strategy. Dipsogenic diabetes insipidus is an uncommonly (and not universally) recognized disorder, requiring monitored testing in order to distinguish it from incomplete forms of central diabetes insipidus. Though therapy with desmopressin cannot be recommended based on the results of a single case, the outcome presented here is intriguing and suggests that larger studies in such patients is warrante Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

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 >>

Diabetes Insipidus Treatment – Treatments For Types Of Di

Diabetes Insipidus Treatment – Treatments For Types Of Di

Diabetes insipidus treatment will depend on what type of diabetes insipidus is diagnosed. There are four different types of diabetes insipidus that share similar symptoms but very different causes and treatments. "Diabetes Insipidus (DI) is a disorder in which there is an abnormal increase in urine output, fluid intake and often thirst. It causes symptoms such as urinary frequency, nocturia (frequent awakening at night to urinate) or enuresis (involuntary urination during sleep or "bedwetting")"(1). Diabetes insipidus treatment – Neurogenic DI The most common type of DI is neurogenic or central diabetes insipidus. This type is caused by a lack of antidiuretic hormone (ADH). Treatment involves providing the body with a synthetic hormone (desmopressin) to make up for the deficiency. Desmopressin is administered as a nasal spray, oral medication or by injection. In mild cases of neurogenic DI, increased water intake may be sufficient to treat the disease and ensure proper hydration. Diabetes insipidus treatment – Nephrogenic DI The second most common type of DI is nephrogenic diabetes insipidus. This type is caused by your kidneys not responding properly to ADH. Treatment may include following a low salt diet and increasing your water consumption. The drug hydrochlorothiazide may help reduce symptoms. Interestingly, this drug is a diuretic, meaning it can be used to increase urination; however, in some patients with nephrogenic DI, it can reduce urine output. Diabetes insipidus treatment – Gestational DI Gestational diabetes insipidus occurs only during pregnancy and may correct itself with 4 to 6 weeks following delivery. Some cases can be helped by the synthetic hormone desmopressin used to treat neurogenic DI. Diabetes insipidus treatment – Dipsogenic DI Dipsoge Continue reading >>

Dipsogenic Diabetes Insipidus

Dipsogenic Diabetes Insipidus

Diabetes insipidus is a condition where the kidneys do not function properly, causing individuals to have to urinate frequently and often become dehydrated. Normally, the kidneys, which are small organs located in the abdomen (belly), filter a person’s blood multiple times a day and create urine. However, when a person has diabetes insipidus, they filter out too much water and create too much urine. This causes the individual to have to urinate more frequently, often every hour of the day and night. There are different types of diabetes insipidus depending on the actual chemical cause of the disorder. Dipsogenic diabetes insipidus is caused by a dysfunction in a certain area of the brain. Onset of diabetes insipidus can occur at any age beyond infancy. Most symptoms of diabetes insipidus can be controlled with medication, and depending on the cause, it may sometimes resolve after a period of time. During this time, however, it is important to have a physician manage the condition to prevent dehydration or other potential consequences of diabetes insipidus. The frequency of diabetes insipidus is 3 in every 100,000 people. Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

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 >>

Diabetes Insipidus

Diabetes Insipidus

Diabetes Insipidus Definition Diabetes insipidus (DI) is a disorder that causes the patient to produce tremendous quantities of urine. The massively increased urine output is usually accompanied by intense thirst. Description The balance of fluid within the body is maintained through a number of mechanisms. One important chemical involved in fluid balance is called antidiuretic hormone (ADH). ADH is produced by the pituitary, a small gland located at the base of the brain. In a healthy person and under normal conditions, ADH is continuously released. ADH influences the amount of fluid that the kidneys reabsorb into the circulatory system and the amount of fluid that the kidneys pass out of the body in the form of urine. Production of ADH is regulated by the osmolality of the circulating blood. Osmolality refers to the concentration of dissolved chemicals (such as sodium, potassium, and chloride; together called solute) circulating in the fluid base of the blood (plasma). When there is very little fluid compared to the concentration of solute, the pituitary will increase ADH production. This tells the kidneys to retain more water and to decrease the amount of urine produced. As fluid is retained, the concentration of solute will normalize. At other times, when the fluid content of the blood is high in comparison to the concentration of solute, ADH production will decrease. The kidneys are then free to pass an increased amount of fluid out of the body in the urine. Again, this will allow the plasma osmolality to return to normal. Diabetes insipidus occurs when either the amount of ADH produced by the pituitary is below normal (central DI), or the kidneys' ability to respond to ADH is defective (nephrogenic DI). In either case, a person with DI will pass extraordinarily la Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst.[1] The amount of urine produced can be nearly 20 liters per day.[1] Reduction of fluid has little effect on the concentration of the urine.[1] Complications may include dehydration or seizures.[1] There are four types of DI, each with a different set of causes.[1] Central DI (CDI) is due to a lack of the hormone vasopressin (antidiuretic hormone).[1] This can be due to damage to the hypothalamus or pituitary gland or genetics.[1] Nephrogenic diabetes insipidus (NDI) occurs when the kidneys do not respond properly to vasopressin.[1] Dipsogenic DI is due to abnormal thirst mechanisms in the hypothalamus while gestational DI occurs only during pregnancy.[1] Diagnosis is often based on urine tests, blood tests, and the fluid deprivation test.[1] Diabetes mellitus is a separate condition with an unrelated mechanism, though both can result in the production of large amounts of urine.[1] Treatment involves drinking sufficient fluids to prevent dehydration.[1] Other treatments depend on the type.[1] In central and gestational disease treated is with desmopressin.[1] Nephrogenic disease may be treated by addressing the underlying cause or the use of a thiazide, aspirin, or ibuprofen.[1] The number of new cases of diabetes insipidus each year is 3 in 100,000.[4] Central DI usually starts between the ages of 10 and 20 and occurs in males and females equally.[2] Nephrogenic DI can begin at any age.[3] The term "diabetes" is derived from the Greek word meaning siphon.[5] Signs and symptoms[edit] Excessive urination and extreme thirst and increased fluid intake (especially for cold water and sometimes ice or ice water) are typical for DI.[6] The symptoms of excessive urination Continue reading >>

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