Diabetes Insipidus

What is Diabetes Insipidus?

Diabetes Insipidus (DI) is a disorder in which the kidneys cannot conserve water, resulting in dehydration. It leads to an imbalance of fluids in the body. It occurs due to insufficient levels of antidiuretic hormone (ADH) or arginine Vasopressin (AVP). This condition also leads to higher production of urine in the body. The patient also might feel more thirsty.

Early Symptoms of Diabetes Insipidus

Diabetes insipidus is unrelated to diabetes yet has some of its symptoms. Diabetes insipidus symptoms are as follows:

  • Increased thirst and need for chilled water (polydipsia) — a person can drink between 2 and 20 L of water daily.
  • Polyuria (frequent urination)
  • Electrolyte loss causes symptoms such as dry mouth, low blood pressure and fatigue, and muscle stiffness.
  • Mental changes, lethargy, and seizures

Types of Diabetes Insipidus

Here are four types of diabetes insipidus, each with a distinct cause:

  1. Central diabetes insipidus (CDI)
  2. Nephrogenic diabetes insipidus (NDI)
  3. Dipsogenic diabetes insipidus
  4. Gestational diabetes insipidus

Central Diabetes Insipidus (CDI) 

Arginine vasopressin (AVP) is a protein in the kidneys that regulate water balance in the body. CDI is caused by a deficiency of AVP, which results in dehydration. Eventually, more severe symptoms related to dehydration can emerge, such as unconsciousness, confusion, and high serum sodium concentration.

Symptoms can develop at any age, gradually or suddenly. In some cases, the condition is so severe that there is no vasopressin activity. Others may have a partial CDI, a milder form of the condition with persistent vasopressin activity. Dehydration occurs quickly if individuals don’t drink water for a long time. Repeated dehydration can cause seizures, brain trauma, developmental issues, and mental impairment.

Cardiovascular symptoms, such as cardiac issues, fever, dry skin, anxiety, seizures, abnormal mental state, and maybe coma, are potential complications of CDI. The most common treatment for central diabetes insipidus symptoms is desmopressin, a substitute for Vasopressin.

Nephrogenic Diabetes Insipidus (NDI)

NDI is a rare condition that affects the kidneys and can either be inherited or acquired. An ADH called Vasopressin secreted by the kidneys is used to maintain the body’s fluid balance, and Arginine vasopressin resistance in the kidneys causes NDI.

Adults with NDI may also get orthostatic hypotension, in which their blood pressure drops dramatically when they stand up or sit down. Orthostatic hypotension can cause dizziness or syncope. People with NDI may be dehydrated very quickly if they don’t drink enough water, are exposed to high temperatures, or are ill at the same time. Complex treatments are needed for NDI.

Dipsogenic Diabetic Insipidus 

Dipsogenic Diabetic Insipidus is not associated with ADH and is induced by excessive fluid intake. It is characterized by excessive thirst and increased hydration due to hypothalamic dysfunction. As a consequence of this, you could feel the need to urinate frequently.

There is no treatment for dipsogenic diabetic insipidus yet. Sugar-free sweets and ice cubes may help lower your thirst by moistening your mouth and promoting saliva production. Taking a little dose of desmopressin may be recommended if you wake up frequently at night to urinate.

Gestational Diabetes Insipidus 

Gestational diabetes insipidus is a condition that affects pregnant women, and insulin resistance is a significant factor in gestational diabetes. Sometimes enzymes produced by the placenta make it difficult for the kidneys to use ADH. Women with multiple pregnancies have more placental tissues and, thus, are at high risk. Diseases and illnesses that alter liver function also increase the risk because the liver controls the vasopressin-degrading enzyme.

After childbirth, gestational diabetes insipidus typically disappears. Desmopressin is an effective treatment that is safe for both mother and child.

Complications Associated With Diabetes Insipidus

As a result of an imbalance in fluid loss and consumption, dehydration is the most common complication of diabetic insipidus. Vital signs of dehydration include lethargy, dizziness, excessive thirst, confusion, and seizures, which may lead to severe brain damage or even death if left untreated.

How Is Diabetic Insipidus Diagnosed?

The doctor may recommend the following tests if diabetes insipidus symptoms are observed:

  • Blood tests
  • Urine tests
  • Water deprivation test that determines the amount of urination without taking fluids
  • Pituitary gland scan using magnetic resonance imaging (MRI)

Precautions and Prevention

  • Consume at least five or six small meals daily.
  • Breakfast should always contain high protein.
  • Manage your insulin levels.
  • Reduce body fat by regular exercise.

In a few cases, there may be no apparent causes of diabetes insipidus. Some patients may suffer due to an autoimmune reaction that leads to damage to the cells by the immune system. Diabetes mellitus is caused by insulin resistance or insufficient insulin, which leads to high blood sugar levels. Diabetes Insipidus, on the other hand, is caused by the brain’s inability to produce ADH, which leads to abnormal kidney function and excessive urination. Most people with this condition can avoid significant issues and live everyday lives when they control their symptoms.

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