Diabetes Insipidus

Diabetes insipidus is a condition in which the body cannot retain enough water. The patient is
excessively thirsty and excretes large amounts of extremely diluted urine - a reduction in fluid intake
does not reduce amounts and consistency of urine excretion. It is a rare condition, affecting
approximately 1 in every 25,000 people. 

Diabetes insipidus is notrelated to diabetes mellitus (sugar diabetes). The termdiabetes on its own
nearly always refers to diabetes mellitus. This article is aboutdiabetes insipidus - the condition
characterized by intense thirst and polyuria (excretion of large amounts of urine). 

In most cases diabetes insipidus occurs because the body does not properly produce, store or release
a key hormone - arginine vasopressin (AVP), also known as antidiuretic hormone (ADH). It may also
occur when the kidneys do not respond properly to ADH (antidiuretic hormone). 

There are three types of diabetes insipidus:

 Neurogenic diabetes insipidus - a deficiency with ADH (antidiuretic hormone).

 Nephrogenic diabetes insipidus - insensitivity of the kidneys to ADH.
 Gestational diabetes insipidus - in very rare cases diabetes insipidus may also occur during
pregnancy.

According to Medilexicon's medical dictionary:

Diabetes insipidus is "Chronic excretion of very large amounts of pale urine of low specific gravity,
causing dehydration and extreme thirst; ordinarily results from inadequate output of pituitary
antidiuretic hormone; the urine abnormalities may be mimicked as a result of excessive fluid intake,
as in psychogenic polydipsia. Two types exist: central and nephrogenic. Autosomal dominant
[MIM*125700, *125800, *192340], X-linked [MIM*304800 and *304900], and even autosomal
recessive forms [MIM*222000] have been described."

What are the signs and symptoms of diabetes insipidus?

A symptom is something the patient senses and describes, while a sign is something other people,
such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a
sign. 

The main signs and symptoms of diabetes insipidus include:

 Extreme thirst - patients find themselves having to drink water all the time. The constant thirst
and a dry feeling are persistent; even after consuming large quantities of water.
 Polyuria - excretion of very large quantities of urine (diluted). Urine output can range from 2.5
liters (2.6 quarts) per day to 15 liters (16 quarts) per day, compared to about 1.5 to 2.5 liters per day
in other adults without the condition.

Patients may find that they need to pass pale, watery urine as often as every 15 to 20 minutes. This
may make it very hard to be out of the house if there is no toilet nearby. In the UK patients may
receive a toilet facility card which allows them to use toilets in non-public places.

The following signs and symptoms are also possible:

 Nocturia - having to get up from sleep to urinate. Disrupted sleeping patterns can lead to fatigue
(tiredness, irritability, and concentration problems.
 Enuresis - bed-wetting
 Feeling unwell - patients commonly feel run down for much of the time.

The following signs and symptoms may be present among young children with diabetes insipidus:

 Cool hands and feet

 Delayed growth (failure to thrive)
 Diapers (UK: nappies) which are excessively wet
 Diarrhea
 Dry skin
 Fever
 Inconsolable crying
 Unexplained fussiness
 Vomiting
 Weight loss (failure to thrive)

Anybody who has excessive thirst and urination should see their doctor as soon as possible.

What are the causes of diabetes insipidus?

Our kidneys remove excess body fluids from our bloodstream. This excess fluid waste is stored as
urine in the bladder. If our body fluid levels drop due to, for example perspiration (sweating), our
kidneys produce less urine in order to maintain a proper body fluid level balance.