Diabetes Insipidus : Symptoms, Types , Complications, Diagnosis, Treatment
Symptoms of diabetes insipidus (DI) the release of a large quantity of urine and an unquenchable thirst. This passing of urine in a large quantity is due to not enough vasopressin which is a hormone from the brain to regulate the release of urine from the kidneys. When too much fluid is given out through the urine, the sufferer has to drink lots of water to replace the lost fluid. In serious cases, the affected person may pass out urine as much as 30 liters a day. Unless treated, a person with diabetes insipidus can suffer from dehydration and, as the salts, especially sodium, in the bloodstream become concentrated, goes into a coma because of the salt concentration.
This health problem has no connection with diabetes mellitus although its name leads one to think there is. The only similarity are the symptoms of passing a big amount of urine and thirst. There are no higher levels of blood glucose in diabetes insipidus. The diabetes in this condition gives the meaning to go through which describes the amount of urine released. The word insipidus tells us the urine has no taste while the word mellitus implies the urine is sweet as a result of the sugar in it. The term takes us into the past when doctors taste the urine to reach a diagnosis.
Symptoms
Diabetes insipidus has the following symptoms:
- Bedwetting.
- Weak muscles.
- Constipation.
- Dry skin.
- Waking often to urinate at night.
- Clear, not pale yellow, urine.
- Large quantity of urine (polyuria).
- A thirst which is unquenchable (polydipsia).
Diabetes Insipidus or Water Diabetes -Video Guide
Too much water is lost in the urine
The kidneys excrete urine. These organs ensure the correct quantity of water and salts in the blood and take away wastes like urea by filtering the blood. The hypothalamus in the brain produces a hormone called vasopressin. Diabetes insipidus can either be due to the kidneys not being sensitive to vasopressin or insufficient vasopressin is produced by the hypothalamus. It leads to the loss of a great quantity of water through the urine, resulting in extreme thirst.
Different types of diabetes insipidus
The cases of diabetes insipidus are grouped by cause such as:
- Neurogenic – Vasopressin is insufficiently produced by the brain. The cause of this could be infection (such as meningitis), head injury, brain tumor, brain surgery or ruptured aneurysm. However, in approximately 50% of the cases, the cause is not known (idiopathic neurogenic diabetes insipidus).
- Nephrogenic - The kidneys do not respond to vasopressin. This is a comparatively rare type of diabetes insipidus which is due to a genetic disorder which affects the tiny structures inside the kidneys, known as tubules, which absorb water. It occurs in more men than women. Nephrogenic diabetes insipidus among adults can be due to hypercalcemia and treatment with lithium.
Possible Complications
If not treated, the possible diabetes insipidus complications are:
- Brain damage.
- Kidney damage.
- Low blood pressure (hypotension).
- Frequent headaches.
- Fatigue.
- Weight loss.
- Heart rate too fast.
- Body temperature too low.
- Chronic dehydration.
Diagnosis Methods
Diagnosis of diabetes insipidus is done with some tests including:
- Computed tomography (CT) scans.
- Magnetic resonance imaging (MRI) scan for the brain.
- Water deprivation test (to determine the amount of urine lost).
- Blood tests to know electrolyte levels.
- Urine analysis.
- Physical examination.
- Medical history.
Treatment options
The cause determines the treatment of diabetes insipidus.Vasopressin is replaced if DI is caused by insufficient vasopressin. In the treatment, vasopressin is absorbed by the nose, through its lining when a small quantity of vasopressin is sniffed. If DI is due to the kidneysâ insensitivity to vasopressin, there will be the need to replace the lost fuids.
Options are:
- Change to a reduced salt diet.
- Drink lots of fluids.
- Medications such as hydrochlorothiazide and other non-steroidal anti-inflammatory medicines can be useful.
Some types of DI, like those which happen during a pregnancy, after a neurosurgery or a head injury can recover after some time.
Remember
- The release of big quantities of urine and excessive thirst characterized Diabetes insipidus.
- It occurs when the brain cannot produce sufficient vasopressin, a hormone which signals the kidneys to keep their fluids.
- Replacing vasopressin is a treatment options.