Diabetes insipidus (DI) is a condition characterized by an imbalance of fluids in the body, resulting in excessive thirst (polydipsia) and the excretion of large volumes of dilute urine (polyuria). This occurs because of a deficiency in the production of the hormone vasopressin (also known as antidiuretic hormone, or ADH) or the body's inability to respond to this hormone.
There are two main types of diabetes insipidus:
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Central Diabetes Insipidus: This form results from damage to the hypothalamus or pituitary gland, often due to head injury, surgery, infection, or tumors. This damage disrupts the production or release of vasopressin.
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Nephrogenic Diabetes Insipidus: This form occurs when the kidneys do not respond properly to vasopressin. It can be caused by genetic factors, chronic kidney disease, certain medications (such as lithium), or electrolyte imbalances (like high calcium levels).
Symptoms of diabetes insipidus include:
- Excessive thirst and a strong desire to drink fluids (polydipsia)
- Frequent urination (polyuria), producing large amounts of dilute urine
- Nocturia (frequent urination at night)
- Dehydration if fluid intake does not keep up with losses
Diagnosis typically involves evaluating symptoms, urinary output, and performing tests such as a water deprivation test or measuring levels of vasopressin. Treatment depends on the type of diabetes insipidus. For central DI, desmopressin (a synthetic form of vasopressin) is commonly prescribed. In cases of nephrogenic DI, treatment may focus on managing symptoms and addressing underlying causes, and medications like thiazide diuretics or nonsteroidal anti-inflammatory drugs (NSAIDs) can sometimes help reduce urine output.
It is important for individuals with diabetes insipidus to maintain adequate fluid intake to prevent dehydration.