Diabetes Insipidus?

What is diabetes insipidus?
Diabetes insipidus is a rare disorder that causes the body to make too much urine. While most people make 1 to 3 quarts of urine a day, people with diabetes insipidus can make up to 20 quarts of urine a day. People with this disorder need to urinate frequently, called polyuria. They may also feel thirsty all the time and drink lots of liquids, a condition called polydipsia.

Are diabetes insipidus and diabetes mellitus the same?
Diabetes insipidus is not the same as diabetes mellitus. Although both conditions can increase thirst, intake of liquids, and urination, they are not related.

In diabetes mellitus, the level of glucose in your blood, also called blood sugar, is too high. Your kidneys try to remove the extra glucose by passing it in your urine.
In diabetes insipidus, your blood glucose levels are normal, but your kidneys can’t properly concentrate urine.
How common is diabetes insipidus?
Diabetes insipidus is rare, affecting about 1 in 25,000 people worldwide.1

What are the complications of diabetes insipidus?
The main complication of diabetes insipidus is dehydration, which happens when your body loses too much fluid and electrolytes to work properly. If you have diabetes insipidus, you can usually make up for the large amount of fluids you pass in your urine by drinking more liquids. But if you don’t, you could quickly become dehydrated.

What causes diabetes insipidus?
Diabetes insipidus is usually caused by problems with a hormone called vasopressin that helps your kidneys balance the amount of fluid in your body. Problems with a part of your brain that controls thirst can also cause diabetes insipidus. Specific causes vary among the four types of diabetes insipidus: central, nephrogenic, dipsogenic, and gestational.2

Central diabetes insipidus
In central diabetes insipidus, your body doesn’t make enough vasopressin, also called “antidiuretic hormone.” Vasopressin is produced in your hypothalamus, a small area of your brain near the pituitary gland. When the amount of fluids in your body falls too low, the pituitary gland releases vasopressin into your bloodstream. The hormone signals your kidneys to conserve fluids by pulling fluids from your urine and returning fluid to your bloodstream. But if your body can’t make enough vasopressin, the fluid may get flushed out in your urine instead.

Gestational diabetes insipidus
Gestational diabetes insipidus is a rare, temporary condition that can develop during pregnancy. This type of diabetes insipidus occurs when the mother’s placenta NIH external link makes too much of an enzyme that breaks down her vasopressin. Women who are pregnant with more than one baby are more likely to develop the condition because they have more placental tissue.3 Because the liver plays a role in curbing the enzyme that breaks down vasopressin, diseases and conditions that affect liver function also increase risk. Examples include preeclampsia NIH external link and HELLP syndrome NIH external link.

How do health care professionals treat diabetes insipidus?
The main way to treat diabetes insipidus is to drink enough liquids to prevent dehydration. But doing so can disrupt your regular lifestyle, including your sleep. Your health care professional may refer you to a specialist, such as a nephrologist or an endocrinologist for more specific treatments. Other treatments vary by cause.

Central diabetes insipidus
Health care professionals most often treat central diabetes insipidus with a man-made hormone called desmopressin NIH external link, which replaces the vasopressin your body is not making.2,6 You can take this medicine as a nasal spray, a pill, or a shot.

Nephrogenic diabetes insipidus
In some cases, nephrogenic diabetes insipidus may go away after treating its cause. For example, switching medicines or taking steps to balance the amount of calcium or potassium in your body may be enough to resolve the problem. Your health care professional may also prescribe a class of diuretic medicines called thiazides to help reduce the amount of urine your kidneys make.2,7 Other treatments can include nonsteroidal anti-inflammatory drugs or other types of diuretics.