Diabetes insipidus is an atypical but manageable illness that results in excessive urine production and compromised water retention in the body. For this reason, it can be temporary, chronic (lifelong), moderate, or severe. Antidiuretic hormone, also known as vasopressin, is responsible for the manifestation of this condition. Either the body needs to produce it more, or the kidneys need to utilize it more effectively.
People with this condition frequently urinate in large amounts and absorb a lot of water because they are constantly thirsty. If you are undergoing any treatment for diabetes insipidus, it is necessary to maintain a certain level of hydration throughout the body. As a rare form of Diabetes, this type becomes a significant condition that requires professional medical treatment. As an uncommon condition, 1 in 25,000 individuals is globally impacted by it.
Which Hormone Is Primarily Responsible For Diabetes Insipidus?
The brain produces an antidiuretic hormone (ADH, also known as vasopressin) that the pituitary gland stores and secretes when necessary. The brain’s hypothalamus regulates both the function of the pituitary gland and the autonomic nervous system. The pituitary gland receives the ADH it produces and stores it for later release.
The kidneys are triggered by the rise in ADH to store more water rather than release it in urination (urine). When an individual is dehydrated or experiences a drop in blood pressure, the body often creates and releases more ADH. By regulating the quantity of water, the kidneys reabsorb while they are filtering waste from the blood, ADH helps maintain the proper balance of water in the body.
Most instances are caused by insufficient ADH production by the hypothalamus, insufficient ADH release by the pituitary gland, or insufficient ADH utilization by the kidneys.
What are the types of Diabetes Insipidus?
Central Diabetes Insipidus
The most prevalent kind of Diabetes insipidus is central diabetes insipidus. It occurs when the body lacks adequate antidiuretic hormone (ADH or vasopressin). Damage to the hypothalamus or pituitary gland might result in CDI.
Nephrogenic Diabetes Insipidus
This occurs when the pituitary gland produces enough ADH, but the kidneys cannot process it adequately. As a result, the individual is not able to retain water.
Dipsogenic Diabetes Insipidus
In this form, the hypothalamus is unrelated to the generation of ADH, making you thirsty and consuming more fluids. As a result, you might need to urinate often.
Gestational Diabetes Insipidus
This disorder, which is rare and very transient, can appear during pregnancy. When the placenta, a temporary organ that feeds the unborn infant, produces an excessive amount of an enzyme that metabolizes ADH, gestational diabetes insipidus develops. Because they have more placental tissue, women carrying multiple babies are prone to acquiring the condition. Pregnancy-related gestational diabetes insipidus often disappears shortly after delivery.
What is the basic difference between Diabetes Mellitus and Diabetes Insipidus?
Diabetes mellitus and diabetes insipidus are two separate diseases with various etiologies and modes of management. Because they result in increased thirst and frequent urination, and both are referred to as “diabetes.”
Diabetes mellitus usually referred to as Type 1 diabetes, Type 2 diabetes, or gestational Diabetes (pregnancy-related), is a condition that develops when the pancreas either produces unsatisfactory amounts of insulin or misuses the insulin that is produced by the body. In order to convert the food one consumes into energy, your body requires insulin.
Without insulin, the body begins converting fat and muscle into ketone as a substitute for glucose as an energy source. The body tries to eliminate excess ketones through urine because too many might cause the blood to become acidic. As a result, severe thirst and frequent urination are typical signs of Diabetes.
When the body doesn’t produce enough antidiuretic hormone (ADH) or the kidneys don’t utilize it effectively, diabetes insipidus develops. ADH is required by the body to retain the proper quantity of water. The body loses water through urination without ADH.
The primary difference between mellitus and insipidus is that the latter is substantially less typical than diabetes mellitus.
Symptoms and Causes of Diabetes Insipudus
Primary Significant Symptoms
The need to frequently pass large amounts of dilute urine and severe thirst are the two basic signs of this form of Diabetes. These symptoms are also referred to as polyuria and polydipsia.
The following conditions might also be signs of Diabetes insipidus:
- Frequent urination
- Bedwetting
- Passing pale urine
- Dry skin
- Constipation
- Muscular weakness
Dehydration and disturbed sleep are other potential consequences of these symptoms. This form of Diabetes can result in irreversible kidney damage if not adequately treated.
Diabetes Insipidus Causes
Low levels of antidiuretic hormone (ADH), referred to as vasopressin, is one of the main causes. How effectively the kidneys store water is influenced by ADH levels. Any malfunctioning system component that controls the body’s fluid balance might lead to Diabetes insipidus.
According to StatPearls, fluids comprise 50 to 60 percent of an adult’s total body mass and about 75 percent of an infant’s.
Your body receives fluids from the meals and liquids you consume throughout the day. Sweating, breathing, and urination all aid in the removal of fluid from the body. General health depends on keeping your body’s fluid levels at the right level.
The body controls bodily fluids through a network of organs and hormone messages. This condition produces more urine when there is an excess amount of fluid in the body and requires more fluid intake when compensating for excess perspiration.
In addition:
- The kidneys play a significant part in fluid control by eliminating surplus fluid from circulation.
- The bladder stores the fluid waste until it is excreted via urine.
- ADH is created in the brain and then stored in the pituitary gland.
- The precise region of the brain where ADH is produced is the hypothalamus. The hypothalamus regulates thirst.
- The pituitary gland releases ADH into circulation when your body requires it to retain water.
- ADH is either released in lower amounts or not when you need to get rid of water, which causes you to urinate more frequently.
Diagnosis and Treatment
Diagnosis
The doctor will do a physical examination and inquire about the patient’s medical history, including that of their family. There may be further exams and procedures.
Urinalysis
A urinalysis can determine your urine’s dilution or wateriness. Additionally, it might indicate whether your blood glucose level is excessively high, indicating Mellitus rather than insipidus.
Blood testing
A blood test can gauge sodium content and other chemical concentrations, which can aid in the identification of Diabetes insipidus and, in certain situations, the type.
Deprivation of water test
The results of this test can be utilized to diagnose and pinpoint the source of Diabetes insipidus. The patient is advised not to drink any fluid a few hours before the test. A medical practitioner will weigh you, measure your urine output, and keep track of any changes in your blood and urine. The medical expert may occasionally administer synthetic vasopressin or other medications during the test.
Magnetic resonance imaging (MRI)
An MRI creates images of the brain tissues using radio waves and magnets. To inspect the damage to your hypothalamus or pituitary gland that might result in this condition, the doctor could perform this test.
Tests of stimulation
You get an intravenous solution throughout these tests, which prompts the body to create vasopressin. The next step is for a medical practitioner to check your blood for copeptin, a chemical that rises as vasopressin develops. Results can reveal whether you have primary polydipsia, a separate illness that can make you drink lots of fluids, or diabetes insipidus.
Diabetes Insipidus Treatment
Drinking sufficient amounts of liquids to avoid dehydration is the major recommendation for treating this condition. However, doing so can interfere with the normal circadian rhythm, including sleeping. The other therapies change depending on the reason. The doctor could suggest more specialized care from a nephrologist or endocrinologist.
Central Insipidus Diabetes
Desmopressin is a synthetic hormone that substitutes the vasopressin the body stops producing. It is the most common treatment medical experts use for central diabetes. This medication comes as an injection, a tablet, or a nasal spray.
Nephrogenic Diabetes Mellitus
After addressing the underlying cause, nephrogenic diabetes insipidus may occasionally disappear. Correcting the calcium or potassium balance in your body may be sufficient to correct the issue. To assist in lowering the volume of urine, the doctor may also prescribe a group of diuretics known as thiazides. Nonsteroidal anti-inflammatory medications and other diuretics are examples of further therapy.
Dipsogenic Diabetes Insipidus
Dipsogenic diabetes cannot currently be effectively treated, according to research. Try sucking on ice chips or sugar-free sweets to quench your thirst, and stimulate saliva production. The doctor might advise you to take a small dosage of desmopressin before bed if you frequently get up at night to urinate.
Gestational Diabetes Insipidus
Desmopressin is a safe medication that medical experts use to treat gestational diabetes insipidus. Unlike vasopressin, desmopressin is not destroyed by the placenta of an expecting mother. After the baby is born, gestational diabetes insipidus normally disappears, although it could come back if the woman conceives again.
Diabetes insipidus must be treated with a lifestyle change. Preventing dehydration is the most crucial activity. If a kid has diabetes insipidus, give them water every few hours or carry it with you wherever you go. The doctor can advise you on the recommended daily hydration intake.
Wear a medical bracelet or have a medical alert card in the wallet to let others know you have diabetes insipidus in case of an emergency. People nearby should be aware of your situation since dehydration might occur suddenly. Researchers have not discovered that food, diet, or nutrition are involved in the development of Diabetes insipidus or its treatment.
Your doctor could advise you to follow a low-protein, low-sodium diet to encourage your kidneys to produce less pee, which will help you feel better.
Conclusion
Having diabetes insipidus causes the body to generate excessive amounts of urine (pee) and has trouble retaining water. The good news is that it can be managed and treated. It’s crucial to routinely visit the doctor if one has this form of diabetes to ensure that the therapy is successful. Ask your medical adviser any questions you may have regarding the situation without hesitation.