Diabetes Insipidus: Causes, Symptoms, and Management
Diabetes insipidus is an uncommon condition that develops when the kidneys are unable to conserve water properly. This results in excessive thirst and the production of large volumes of diluted urine. Despite sharing the name “diabetes,” this condition is not related to diabetes mellitus (blood sugar disorders).
In Canada, diabetes insipidus is treatable when properly diagnosed, but untreated cases can quickly lead to dehydration, making early recognition essential.
Types of Diabetes Insipidus
Central Diabetes Insipidus
This is the most common form and occurs when the pituitary gland or hypothalamus is damaged. As a result, the body cannot produce, store, or release enough antidiuretic hormone (ADH), which normally helps the kidneys regulate fluid balance.
Dipsogenic Diabetes Insipidus
This form results from a dysfunction in the thirst mechanism in the brain, causing excessive fluid intake. The exact cause is unclear, but it has been linked to:
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Sarcoidosis
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Certain mental health conditions
Nephrogenic Diabetes Insipidus
In this type, the kidneys do not respond properly to ADH. Possible causes include:
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Certain medications
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High calcium levels
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Polycystic kidney disease
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Sickle cell disease
Gestational Diabetes Insipidus
This form occurs only during pregnancy and is caused by an enzyme produced by the placenta that breaks down ADH.
In some individuals, the exact cause of diabetes insipidus cannot be clearly identified.
Risk Factors
Diabetes insipidus can affect anyone, but:
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Most forms (except gestational) occur more often in males
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There may be a hereditary link in certain cases
Signs and Symptoms of Diabetes Insipidus
The primary symptoms include:
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Extreme thirst (polydipsia)
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Excessive urine output (polyuria)
Daily urine output may range from 2.6 to 16 quarts, compared to the normal 1.6–2.4 quarts per day. Many individuals also wake frequently at night to urinate or experience bedwetting.
Symptoms in Infants and Young Children
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Dry skin
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Fussiness or excessive crying
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Fever, vomiting, or diarrhea
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Unusually wet diapers
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Weight loss
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Delayed growth
A healthcare professional should be consulted immediately if these symptoms are present.
Management of Diabetes Insipidus
Treatment depends on the type and severity of the condition.
Hormone Treatment
The primary treatment is desmopressin, a synthetic form of vasopressin (ADH). It may be administered as:
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Nasal spray
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Oral tablet
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Injection
When using desmopressin, individuals must carefully regulate fluid intake and drink only when thirsty to avoid water imbalance.
Medications
Nephrogenic diabetes insipidus may be treated with:
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High-dose desmopressin
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Indomethacin
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Hydrochlorothiazide
Treating Underlying Conditions
If diabetes insipidus is caused by another medical condition, that condition is treated first, followed by reassessment.
Dietary and Lifestyle Adjustments
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Low-salt diet to reduce urine output
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Constant access to drinking water
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Careful monitoring to prevent dehydration
Important Disclaimer (Embedded)
Educational Use Only
This content is intended for first aid awareness and health education in Canada. It does not replace medical diagnosis or treatment. Excessive urination, dehydration, or altered consciousness requires prompt medical assessment.