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Diabetes insipidus: Treatment, symptoms, advice and help

About diabetes insipidus

Diabetes insipidus is a hormonal disorder involving the anti-diuretic hormone (ADH) also called ‘vasopressin’ which is responsible for concentrating urine. The kidneys under influence of this hormone conserve water from the urine before it is excreted from the body. Any deficiency in ADH or a failure on the part of the kidneys to respond to ADH may result in increased production of dilute urine.

Diabetes insipidus is different and not related to diabetes mellitus except for increased urine output which is a prominent symptom in both.

Diabetes insipidus: Incidence, age and sex

Individuals of all age groups irrespective of gender may get afflicted with diabetes insipidus. It is not an uncommon condition and may be encountered anywhere in world irrespective of the socio economic status.

Signs and symptoms of diabetes insipidus: Diagnosis

Diabetes insipidus is characterised by an abnormal increase in urine output which may be accompanied by excessive thirst. Increase in the frequency of urine especially at night may be noted. Occasionally, some individuals may exhibit poor bladder control and involuntarily pass urine. The diluted urine may be characteristically colourless and pale.

This condition may be easily diagnosed by documenting urine output and performing urinanalysis. A special test called ‘water deprivation test’ is used to establish the diagnosis of diabetes insipidus. Imaging tests of the brain may be done to evaluate the cause of this disorder.

Causes and prevention of diabetes insipidus

The anti-diuretic hormone (ADH) also called ‘vasopressin’ is produced by hypothalamus from where it is transferred to the pituitary gland for storage until release. In normal circumstances ADH acts upon kidneys which are responsible for concentrating the urine. However, certain conditions like head injuries, meningitis, encephalitis, brain surgery or brain tumour may hamper the production or release of ADH and result in this hormonal disorder. Diabetes insipidus may also result from polycystic kidney disease wherein the kidneys fail to respond to the anti-diuretic hormone. It may also be seen in women during pregnancy or it may occur in individuals with a positive family history. Sometimes medications like lithium may also cause diabetes insipidus.

Diabetes insipidus: Complications

The only complication of diabetes insipidus is dehydration which may result from excessive fluid loss in the urine. The dehydrated individual may show signs like dryness of the mouth, sunken eyes, dry and pinched skin, lethargy and palpitations. If dehydration is not managed timely, it may worsen leading to an electrolyte imbalance and occasional seizures.

Diabetes insipidus: Treatment

Diabetes insipidus is not a very grave condition. Nevertheless, evaluation and management of the underlying cause along with adequate rehydration is essential. Diabetes insipidus arises due to a problem in the hypothalamus or the pituitary gland may be treated by giving vasopressin in form of a tablet or spray. Immediate cessation of lithium intake is advised in individuals who have been prescribed with it. Moreover medication like indomethacin which is a NSAID, has proved beneficial in reducing urine output in some individuals. Diabetes insipidus which may have been caused due to pregnancy does not require any treatment apart from adequate intake of fluids. It usually disappears on its own within a month after delivery.

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