Diabetes Insipidus suffers on average only 1 in 25,000 people.
Nevertheless, this disease is associated with a rapid cut in your lifestyle for those affected.
The need to drink a large glass of water every 15 minutes often results in many toilet breaks.
Unfortunately, diabetes insipidus is not curable.
Anyone who suffers from it, has a great likelihood to fight it for life.
Nevertheless, at least in diabetes insipidus centralis with the desmopressin drug can be administered, which replaces the no longer functioning vasopressin.
And thus makes the disease a bit bearable.
- Diabetes Insipidus is a disorder that causes imbalance in body fluids.
- Diabetes mellitus and diabetes insipidus are not related.
- The big problem is with the kidneys.
- The hormone vasopressin is responsible for the regulation of the fluid. In diabetes insipidus this does not work as well as in healthy people.
- There are several types of diabetes insipidus. These include diabetes insipidus centralis and nephrogenic diabetes insipidus (renalis).
What is Diabetes insipidus?
Diabetes Insipidus can be considered as a very rare disorder, which causes an imbalance of body fluids, so to speak.
This leads to the affected person that even despite consumption of plenty of liquid is still thirsty.
Even if he should not be thirsty at all.
Conversely, this results in the production of large quantities of urine.
The urine is very diluted and also odorless.
In order to be able to eliminate the following error as soon as possible, the following explanation follows.
Diabetes insipidus and diabetes mellitus are not related.
Diabetes mellitus is the most common type of diabetes.
This can occur as type 1 and type 2 diabetes.
Also, the “normal” diabetes can cause a phenomenon that results in frequent urination and a constant thirst.
However, this has other causes.
The first major difference is that the thirst and frequent urination in diabetes mellitus is due to high blood sugar levels.
On the one hand, this can lead to a disruption in the production of insulin (type 1).
It is often produced at all or only very little insulin.
Or the body is no longer able to process the insulin fast enough (type 2).
This is different in people who have diabetes insipidus.
These usually have normal blood glucose levels.
The big problem, however, is the kidneys.
These are no longer able to process fluid in the body.
It is also important to know that there is no cure for diabetes insipidus.
However, a treatment is possible.
So it is quite possible to relieve the thirst and reduce urine output.
It comes to these symptoms!
Diabetes insipidus has certain signs and symptoms.
In the first place, this is the extreme thirst.
This results in a lot of drinking.
This in turn means that frequent visits to the toilet are the rule.
Consuming these large amounts of drinks often also causes the person concerned to get up at night frequently to urinate.
In passing, many diabetes insipidus patients also develop a taste for cold drinks.
As we now know, the thirst results in a lot of drinking.
This, in turn, can result in the urine output being up to 20 liters per day.
However, one only becomes aware of this amount when compared to the urine output of a healthy adult.
On average, this is in a healthy adult, namely only between 1 and 2 liters per day.
What causes are there?
If we want to understand the cause of diabetes insipidus, we have to ask ourselves what the kidneys have to do with it now.
In short, the cause of diabetes insipidus is the kidney.
But before I explain why this is so, it must first be defined what the kidneys are actually and what tasks you perform.
Every healthy person has two kidneys.
These are two bean-shaped organs that are about the size of a fist.
You are right under the rib cage.
With one left and one right of the side of the spine.
The main task of the kidneys is the filtering of the blood.
Every day, they filter between 120 and 150 liters of blood and produce about 1 to 2 liters of urine from the waste.
When the urine has left the kidneys, it flows through the ureters from the kidneys to the bladder.
The bladder in turn has the task to store the urine.
When it comes to emptying the bladder, the urine flows through the urethra, which is at the bottom of the bladder out of the body.
The body is responsible for the regulation of the absorbed fluid.
This works by balancing the absorbed fluid and removing excess from the body in turn.
Thirst in turn has the task to regulate the fluid intake of a person.
This is where the hormone vasopressin comes into play.
This is a substance made by the body.
This occurs in a part of the brain called the hypothalamus.
Subsequently, the vasopressin is then stored in the pituitary gland.
Roughly speaking, the vasopressin urges the kidneys to stick to the fluid.
This leads to the formation of urine.
The resulting excess liquid is now transferred to the bladder.
Similar to blood sugar, there is also a vasopressin level.
When we are thirsty, the vasopressin level rises.
The kidneys now absorb more fluid and release concentrated urine.
Now, when you’ve been drinking too much, the body signals to the brain that it’s time to visit the restroom.
With the emptied bladder now also the vasopressin level decreases.
Important! Vasopressin is also known as antidiuretic (ADH).
This is especially important because we use this term later in the post.
In healthy people, the hormone vasopressin now ensures that the body is able to regulate the absorbed fluid.
In diabetes insipidus patients, however, this control function does not work as it should.
However, what exactly does not work here as it should actually is different for every type of diabetes insipidus disease.
In this article, we discuss the two most common types and gestational diabetes insipidus.
These two most common types of diabetes insipidus disease are also referred to as diabetes insipidus centralis and as nephrogenic diabetes insipidus or diabetes insipidus renalis.
What types of diabetes insipidus are there?
Diabetes insipidus centralis
When you suffer from diabetes insipidus centralis, the body does not produce enough of the hormone vasopressin.
Earlier in the article, we learned that the hormone vasopressin controls how much urine the kidneys release.
Without enough vasopressin, the kidneys are no longer able to work properly.
The result then is that the body quickly loses much water in the form of diluted urine.
Because of this, sufferers are very thirsty and drink a lot.
On average, only about 1 human 25,000 suffer from diabetes insipidus centralis.
Often the cause of the disease is unclear.
Possible causes include damage to or injury to the hypothalamus or pituitary gland.
This damage can be caused, for example, by surgery, head trauma, infection, and inflammation.
In order to prevent this condition as much as possible, it is important to treat injuries, infections and tumors as soon as possible.
The following symptoms occur in diabetes insipidus centralis:
Frequent urination – more than 3 liters of urine per day
Frequent awakening at night to go to the bathroom
Involuntary urination during sleep (bedwetting)
Pale, colorless urine
Low measured urine concentration
Extreme thirst – often drink more than 1 gallon of fluid per day
Diabetes insipidus centralis is often diagnosed as such.
If the doctor now suspects that a disease is present, the urine is often examined.
In addition to a urine test, a water restriction test can also be carried out.
This checks how well the kidneys are working.
This includes checking how much urine they produce and how much sodium is in the blood plasma.
Depending on the diagnosis, vasopressin may have to be taken.
In mild diabetes insipidus centralis is sufficient for the treatment that more water is drunk.
In certain cases, however, a vasopressin-like hormone must also be taken.
Often this is desmopressin or DDAVP.
Desmopressin makes it possible to regulate urine output.
At the same time it maintains the liquid balance and prevents dehydration.
Nephrogenic diabetes insipidus (renalis)
In nephrogenic diabetes insipidus, often referred to as diabetes insipidus renalis, the kidneys can not sufficiently respond to the hormone antidiuretic (vasopressin).
This is responsible for the regulation of the fluid balance.
As a result, it leads to excessive urination and thirst.
Antidiuretic is known to be produced in a part of the brain called the hypothalamus and then stored in the pituitary gland.
Released it triggers a fluid loss.
This is also called dehydration.
So, when it’s released, the kidneys hold back fluid.
This in turn results in a decrease and concentration of urine.
The problem with nephrogenic diabetes insipidus is not that too little antidiuretic is produced.
Rather, it is because the kidneys do not recognize it for the most part and are blind to it.
Because of this, the antidiuretic flows past almost without effect.
The kidneys, on the other hand, do not absorb enough water and therefore excrete much diluted urine.
So as if the antidiuretic (vasopressin) would not be present.
The symptoms of nephrogenic diabetes insipidus are expressed in excessive thirst as well as in excessive urine production (polyuria).
Some people suffering from nephrogenic diabetes insipidus have to drink a large glass of water every 15 minutes.
However, as the kidneys are no longer able to retain the fluid, it often causes these people to go to the bathroom.
If we look at the causes of nephrogenic diabetes insipidus, we have to distinguish between development in infants and adults.
In children, nephrogenic diabetes insipidus can be caused by a genetic mutation caused at birth.
As a result, the receptor for the antidiuretic does not function properly.
In adults, however, genetics is not the reason for the disease.
In many cases, medication or electrolyte disturbances are the reasons for this.
More about electrolyte imbalances can be found in the chapter on the possible complications of diabetes insipidus disease.
About 20 percent of people who take lithium develop neprogenic diabetes insipidus.
But not only lithium triggers the disease.
Other drugs such as demeclocycline, ofloxacin and orlistat may also be the cause.
In addition, a high calcium level as well as a low potassium level in the blood can also cause diabetes insipidus renalis (nephrogen).
Treatment is largely unsatisfactory here.
This is because the kidneys are no longer responding to the antidiuretic.
Therefore, it makes no sense to administer the antidiuretic (vasopressin).
Gestational diabetes insipidus
During pregnancy, a gestational diabetes insipidus develop.
In this disease it comes to the fact that the person is very thirsty and it has to take a lot of water daily.
Far more common, however, is the normal gestational diabetes.
Can diabetes insipidus be treated?
Basically, we can say that there is no cure for diabetes insipidus.
However, there are certain treatments to relieve thirst and reduce urine output.
At the first treatment a lot of water must be drunk.
This helps to prevent dehydration.
The doctor may also refer the patient to a nephrologist.
He specializes in the treatment of kidney problems.
Or if the hormone-producing glands are disturbed, to an endocrinologist.
The treatment depends entirely on the type of disease.
Thus diabetes insipidus centralis must be treated differently than nephrogenic diabetes insipidus.
Diabetes insipidus centralis
This is where the hormone desmopressin comes into play.
This can treat diabetes insipidus centralis.
In this type of diabetes insipidus, it is well known that not enough is produced in vasopressin.
Therefore, the desmopressin occupies the place of vasopressin, so to speak.
It can be administered as an injection, nasal spray or as a pill.
Through this treatment, the symptoms of diabetes insipidus centralis can be better controlled.
Nevertheless, it can not cure the disease.
Nephrogenic diabetes insipidus
As we know, the cause of nephrogenic diabetes insipidus disease is often due to the ingestion of medications or high calcium levels or levels of potassium in the blood.
In some cases, eliminating the cause, such as changing medicines, can remedy the condition.
This is how it is diagnosed!
Diabetes Insipidus is mostly detected by the following criteria:
- medical and family history
- physical examination
- blood tests
- Fluid deprivation test
- Magnetic Resonance Imaging (MRI)
Why are children often affected?
As you have already heard several times, diabetes insipidus is triggered by too little vasopressin (antidiuretic) in the body.
At the same time, this hormone is actually responsible for allowing the kidneys to hold the right amount of water in the body.
The causes that diabetes insipidus forms in a child are manifold. The following diseases can be such a trigger:
- A hypothalamus gland that does not produce enough ADH
- A pituitary gland that does not release enough ADH into the blood
- damage to the hypothalamus or pituitary during surgery or radiotherapy
- brain injury
- brain tumor
- Obstruction of the arteries leading to the brain
- inflammation of the brain (encephalitis)
- inflammation of the membranes covering the brain and spinal cord (meningitis)
- family inheritance
- Certain medications like lithium
Most children fall ill with Diabetes Insipidus if they have previously had a head injury, had brain surgery, suffered from a brain tumor or kidney disease.
In addition, the use of certain medications such as lithium may be responsible for the development of diabetes.
The disease can be recognized by the fact that the child is more thirsty than normal, and often has to go to the bathroom and suffers from dehydration or weight loss.
Especially for very young children, diabetes insipidus disease can lead to irritability, poor growth and high fever.
Diabetes insipidus can be detected in a child by a urine test, by a blood test as well as by an MRI.
What are the complications of diabetes insipidus?
The two main complications of diabetes insipidus are dehydration and electrolyte imbalance.
Especially if the disease has not been diagnosed, complications are more common.
In diabetes insipidus it is difficult for the body to retain enough water.
This results in the need to constantly drink liquid.
If now too little drunk, it comes quickly to dehydration and a strong lack of water in the body.
The positive thing is that dehydration can be treated by balancing the water level.
However, by implication, this also means that a lot has to be drunk.
And that this results in constant toilet breaks.
In case of excessive dehydration it may also be necessary to take an intravenous fluid.
However, this should be done by the doctor.
In addition to the risk of dehydration, diabetes insipidus can also trigger an electrolyte imbalance.
Electrolytes are minerals in the blood that have a low electrical charge.
These are, for example, sodium, calcium, potassium, chlorine and magnesium and bicarbonate.
If it comes to the fact that the body loses too much water, it can lead to an increased concentration of electrolytes.
As a result, dehydration and the concentration of electrolytes cause other problems.
For example, headache, persistent fatigue, irritability and muscle aches.