Diabetes Insipidus is a medical problem that is completely different from the more common Diabetes (Blood Sugar problem). While often confused with type 1 or type 2 diabetes mellitus, diabetes insipidus (DI) is a distinct condition affecting your body's water balance.
What is Diabetes Insipidus (DI)?
Diabetes insipidus (DI) refers to a group of rare disorders characterized by excessive thirst and urination. Unlike diabetes mellitus, it's not due to issues with blood sugar control but with the hormone Vasopressin (antidiuretic hormone, ADH). This hormone helps your kidneys conserve water, and when it's malfunctioning, your body loses excessive amounts through urine.
Antidiuretic Hormone, ADH:
It is a vital hormone produced by the hypothalamus in the brain and stored in the pituitary gland.
It is released into the bloodstream in response to various factors like:
- Decreased Blood Pressure: Triggers ADH release to constrict blood vessels and raise blood pressure.
- Increased Blood Osmolality: High concentration of solutes in your blood signals dehydration, prompting ADH release.
- Decreased Blood Volume: Signals the body's need to conserve water, leading to ADH release.
How Does ADH Regulate Water Balance?
It binds to specific receptors in the kidneys, promoting water reabsorption. Less water gets excreted as urine, allowing the body to retain more fluid.
This maintains:
- Blood Volume: Ensures adequate blood pressure and circulation.
- Electrolyte Balance: Prevents imbalances that can affect various body functions.
- Hydration: Keeps cells and tissues properly hydrated.
Causes of Diabetes Insipidus:
DI can be caused by several factors:
- Central DI: This refers any causes effecting the brain – either damage to the hypothalamus or pituitary gland or the pituitary stalk can disrupt disrupts ADH production. This can due to head injury, infections, inflammations, tumor, or due to surgical interventions.
- Nephrogenic DI: The kidneys become resistant to ADH, even if it's produced normally, leading to water loss. This can be caused by genetic disorders, medications, or chronic kidney disease.
[ Read: Diabetic Nephropathy Causes, Signs, Symptoms and Treatment ]
- Gestational DI: A temporary form occurring during pregnancy due to placental factors affecting ADH.
Risk Factors of Diabetes Insipidus:
Certain factors increase your risk of developing DI:
- Head injury or brain surgery is a risk factor as well as a cause.
- Autoimmune diseases
- Kidney Disorders – Chronic kidney disease can lead to secondary Diabetes Insipidus.
- Certain Medications - Consumption of certain medicines over a long period of time can cause Diabetes Insipidus or increase it’s risk or may contribute to worsening it.
- For example, Lithium used in treatment of Bipolar disorder is one of the commonest drugs leading to DI. Demeclocyclin and Ofloxacin may worsen already existing DI. Orlistat a weight loss medication can interfere with ADH secretion in the kidneys. Cisplatin is a chemotherapy drug that can lead to kidney damage and interfere with ADH action.
- Family History of DI. In rare cases, central Diabetes Insipidus can be inherited: This is known as familial CDI. Families with a history of CDI should be aware of the increased risk for their offspring. Several types of kidney associated (Nephrogenic) Diabetes Insipidus are caused by inherited mutations affecting the vasopressin receptors in the kidneys, preventing them from responding to ADH properly.
- Different Patterns of Inheritance Exist: X-linked inheritance (more common in males), autosomal recessive inheritance (both parents carry the gene), and autosomal dominant inheritance (only one parent needs to carry the gene) are possible.
Diabetes Insipidus Symptoms:
Common symptoms of DI include -
- Excessive Thirst: You may constantly feel thirsty and drink large amounts of fluids.
- Frequent Urination: Passing large volumes of dilute (pale) urine, often at night. This is quite distressing and disturbing.
- Dehydration: Despite drinking a lot, you may still experience dehydration symptoms like fatigue, dry mouth, and headache.
- Bedwetting in Children
Diabetes Insipidus Treatment:
Treatments for DI depend on the specific type and cause:
- Central DI: Replacing ADH through nasal spray, injection, or implant to regulate water balance.
- Nephrogenic DI: Treating the underlying kidney problem if possible, potentially using a combination of medications and dietary changes.
- Gestational DI: Usually resolves after childbirth, but may require temporary ADH administration in severe cases.
Diabetes insipidus is a rare but manageable condition. Anytime anyone feels an excessive thirst or increased urination, a qualified doctor must be consulted immediately to get a proper diagnosis and treatment plan. Early diagnosis and proper management can help control symptoms and prevent complications.
