Diabetes Insipidus is a condition in which the body excretes a large amount of dilute urine followed by extreme thirst and dehydration. The condition is not so common and arises due to deficiency or damage done to the part of the brain that secretes Anti-diuretic hormone or Vasopressin. Our endocrine system releases ADH Antidiuretic hormone in the body which is responsible for maintaining body fluids by conserving the required water in the body. Diabetes Insipidus is not related to Diabetes Mellitus rather it occurs due to deficiency or autoimmune resistance to ADH. When adequate fluids and water are not absorbed in the body, it leads to severe symptoms like dehydration, dryness of the main body organs, and restlessness due to intense and unquenched thirst. There is no proper and proven treatment of Diabetes Insipidus but there are some guidelines to reduce the severity of the symptoms. 

There are 4 main types of Diabetes Insipidus:

1. Central Diabetes Insipidus: It is the deficiency of ADH, released from the pituitary gland.

2. Nephrogenic Diabetes Insipidus is caused by the abnormality of the kidneys to absorb body fluids. It happens when the kidneys do not respond to ADH. 

3. Dipsogenic Diabetes Insipidus: A condition that occurs due to the defect of the thirst mechanism, as a result of damage done to the hypothalamus.

4. Gestational Diabetes Insipidus: It happens during pregnancy when placenta enzymes destroy ADH.

The Major Causes of Diabetes Insipidus

The causes of diabetes insipidus are associated with its type.

1. Central Diabetes Insipidus

? Head injury

? Tumors or infections affecting the pituitary or hypothalamus

? Surgery near the pituitary gland

? Genetic mutations

? Idiopathic (no known cause)

2. Nephrogenic Diabetes Insipidus

? Genetic disorders affecting kidney response to ADH

? Chronic kidney disease

? Medications like lithium

? Electrolyte imbalances

3. Dipsogenic Diabetes Insipidus

? Mental health conditions

? Brain injury or surgery affecting the hypothalamus

4. Gestational Diabetes Insipidus

? Enzyme activity during pregnancy

What are the Main Symptoms of Diabetes Insipidus?

Diabetes Insipidus symptoms are associated with the type of the disease and vary according to it. The common symptoms observed by the experts are:

1. Polyuria: It is a condition in which there is excessive production of dilute urine in the body (almost 3 liters/day).

2. Polydipsia: There is an abnormal thirst and feeling of dryness in the body and a person tends to drink a large amount of fluids.

3. Nocturia: Frequent urination urge especially during the night.

4. Dehydration: Lack of required water and fluids in the body leads to dry skin, fatigue, dizziness and confusion.

Diagnosis of Diabetes Insipidus

Diabetes Insipidus diagnosis involves a combination of medical check-ups, physical examination and specific tests to determine the type of diabetes insipidus.

• Medical History and Physical Examination

It is the complete examination of your previous medical history including injuries, surgeries or operations, particularly around the head area. Symptoms like polyuria, polydipsia and nocturia are also observed during this process.

• Urinalysis 

A urine test is performed to examine its composition. 

• Water Deprivation Test

The production of ADH and the body’s reaction to the deficiency of water are examined through a water deprivation test, in which the individuals are advised not to intake water for a specific time period.

• Blood Test

Any imbalance in the body's electrolytes and levels of ADH in the blood are examined through a blood test.

• MRI Scans

MRI scans help in detecting the abnormality or any damage done to the parts of the hypothalamus or pituitary gland.

• DNA Testing

The genetic history of an individual to identify mutations relevant to the abnormal functioning of ADH is checked through a DNA test. It is mainly done in nephrogenic diabetes insipidus. 

What is the Treatment of Diabetes Insipidus?

There is no permanent treatment for Diabetes Insipidus but some medications and precautions relevant to its type, are necessary to control its severe effects on health. 

• Central Diabetes Insipidus

Desmopressin is a synthetic hormone that works exactly like ADH, is mainly prescribed by physicians to reduce urine production and maintain fluids in the body. Other precautions include reduced salt intake and drinking a large amount of water.

• Nephrogenic Diabetes Insipidus

Hydrochlorothiazide is given in this condition, which causes a mild dehydration to increase the sensitivity of the kidney to ADH. In some cases, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are also given to reduce urine production. 

• Dipsogenic Diabetes Insipidus

This type is mainly related to psychological illness to drink plenty of water. Physicists recommend behavioral adaptation and psychological counseling that helps them reduce water intake or fluid consumption.

• Gestational Diabetes Insipidus

It is recommended to take excessive water to prevent dehydration. Desmopressin is also given in this situation to aid kidneys to retain water and maintain electrolyte balance.

How to Prevent Diabetes Insipidus

It is a rare abnormality that has no permanent cure but some limited preventive measures for Diabetes Insipidus can countereffect its health hazards. 

• Avoid severe head injuries by wearing helmets and protective gear while driving or doing any high-risk activity. But if it happens by accident, immediately consult your physician.

• Early treatments of individuals having brain injuries, infections and tumors may decrease the risk of DI.

• Proper knowledge about the careful usage of medications and drugs.

• Avoid the factors that cause kidney disorders or Chronic kidney disease.

• Genetic counseling is important for individuals who have hereditary forms of DI.

• Take immediate medical attention to the symptoms of Diabetes Insipidus to prevent its severe impacts on the body and health.

Diabetes insipidus is caused by factors that are not in human control like deficiency of ADH, any damage done to the Hypothalamus or any genetic abnormality. Therefore, there are limited steps to control it through precautions.

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Complications

Untreated Diabetes Insipidus can lead to serious complications. 

• Constipation is a major complication that occurs due to excessive urination and loss of water from the body during Diabetes Insipidus.

• Hemorrhoids are another serious disorder that occurs due to severe constipation as a result of dehydration. A constipated person feels the need to strain during bowel movements which results in the formation of hemorrhoids. The situation can worsen for individuals who are already having hemorrhoids.

• Other complications include difficulty in sleeping, vomiting, weight loss, headache, restlessness, fever, lethargy, vision problems, etc. 

How to Avoid Complications during Diabetes Insipidus

• Drinking a maximum amount of water on a daily basis may help to reduce dehydration in the body

• Taking laxatives during constipation may prevent straining during bowel movements.

•  Eating fresh and fiber-rich organic food like vegetables and fruits and drinking fresh juices prevents such complications.

 

Diabetes Insipidus is a rare but chronic disorder that affects our health in various ways by causing other complications like constipation and hemorrhoids due to severe dehydration in the body. A detailed awareness and a complete medical check-up is necessary for someone having diabetes insipidus symptoms to avoid further serious complications.