Diabetes Insipidus - Symptoms, Causes, Diagnosis, Prevention and Treatment

What is Diabetes Insipidus?

Diabetes insipidus is a chronic endocrine disorder that affects the production of a hormone called vasopressin. It's caused by an inability to concentrate the urine, and it's characterized by excessive daytime urination and extreme thirst – or, in other words, constant dehydration.

Currently, there is no cure for diabetes insipidus – but luckily there are two treatments available. The first treatment involves fluid restriction to control the loss of fluids through urination. This often helps patients to feel better and reduces their need for hospitalization.

Symptoms

All of these symptoms are caused by excessive urination. When people with diabetes insipidus drink water, they urinate it out again straight away – without even absorbing it into their bloodstream first. This is why patients often feel thirsty, and this is also why they're constantly urinating. It's not just urine volume that increases – it's also the frequency of urination.

Causes

Diabetes insipidus can be caused by several different things, which include:

·    Menopause – Many women will experience post-menopausal excess production of vasopressin at some point in their life. This is the most common cause of diabetes insipidus among older women.

·    Diabetes – Patients who have had type II diabetes for a long time may experience a reduction in the amount of vasopressin their body produces.

·    Physical head injuries – A head injury can sometimes result in several different changes to the brain, and this includes changes to the hypothalamus – an area associated with hormone production.

Diagnosis

The first step of diagnosis is generally a blood test, which will be used to determine levels of vasopressin hormone present in your bloodstream. If your levels are found to be significantly lower than normal, then you're likely to be diagnosed with diabetes insipidus.

Treating diabetes insipidus is primarily focused on controlling the loss of urine and electrolytes.

There are two main treatments for diabetes insipidus: Fluid restriction and vasopressin administration.

·    Fluid restriction is the treatment that most people with diabetes insipidus use, and it's based primarily on trial and error. This treatment aims to control the loss of fluids through urination, which can be done by restricting fluids in patients' diets. If fluids need to be added back in, then the goal is to add in one gram of fluid for every 100 mg of vasopressin in your body.

If fluid restriction doesn't work, then there is also the option of administering vasopressin. This can be done in one of two ways:

·         Intravenous administration – This involves injecting vasopressin directly into your bloodstream. It's the most effective way of treating diabetes insipidus, but it's also the most invasive form of treatment, so it's used as a last resort option. Most people with diabetes insipidus will not receive this form of treatment because it requires hospitalization and surgery.

·    Vaginal administration – This is less invasive than intravenous administration, but it's not quite as effective. It is, however, the cheapest form of treatment.

Prevention

If you have diabetes insipidus, then it's important to keep a close eye on your blood sugar levels. If you're diabetic, then your blood sugar levels must be kept as low as possible – ideally below 7 mmol/L – although below 5 mmol/L is often enough.

Treatment

In most cases, doctors will need to perform several different tests to come up with a treatment plan.

Once a doctor has decided on the best course of action, patients usually start with a short period of fluid restriction. This involves limiting the amount of water you drink each day and is designed to increase the amount of water your body retains. The doctor will also want to organize further tests, such as an MRI scan and possibly an ultrasound scan. If your fluid levels don't improve after two weeks, then you may be asked to go to the hospital.

Frequently Asked Questions on Diabetes Insipidus

What are the symptoms of diabetes insipidus?

Patients with diabetes insipidus usually experience excessive urination. This is the most common symptom, but it's not the only one. Many patients also experience severe thirst, dry mouth, constipation, fatigue, and lethargy.

What causes diabetes insipidus?

There are several different causes of diabetes insipidus, but they have in common a reduction in the amount of vasopressin hormone in people's bloodstreams. It's possible that menopause can also be a cause of diabetes insipidus in women.