Diabetes insipidus occurs when the kidneys pass more urine through the body than normal. The large volume of liquid is odorless and dilute. While the kidneys usually pass one to two quarts per day on average, diabetes insipidus causes three or more quarts of urine per day. In some cases of diabetes insipidus, the body may pass up to 20 quarts per day. Diabetes insipidus is a rare disorder and is not related to diabetes mellitus, which is Type 1 and Type 2 diabetes. Diabetes mellitus is linked to high blood sugar and the body’s inability to turn it into energy. On the other hand, diabetes insipidus involves the kidneys not balancing fluids throughout the body. People with this form of diabetes can have normal blood glucose levels.
A kidney is a bean-shaped organ, about the size of your fist. People are born with two kidneys although they can live with just one. The kidneys are located right below the rib cage with one on either side of the spine. The primary function of the kidney is to filter anywhere from 120 to 150 quarts of blood every day. They are also responsible for producing one to two quarts of urine on a daily basis. The urine flows through tubes called ureters from the kidneys to the bladder. Urine is composed of wastes and fluids. Your bladder stores the urine until it is full. At that time, the body must release the urine through a tube at the bottom of the bladder called the urethra.
A part of your brain called the hypothalamus produces a substance called antidiuretic hormone (ADH). It is stored in the pituitary gland. ADH tells the kidneys to hold water, which, in turn, makes the urine more concentrated. Your ADH levels increase when you are thirsty or dehydrated slightly. After quenching your thirst, the ADH levels drop, which creates pale or diluted urine. ADH is also known as vasopressin.
There are four types of diabetes insipidus. The most well-known may be gestational diabetes. This condition only happens during pregnancy to some women. For some ladies, the placenta makes an enzyme that affects the kidney’s sensitivity to an ADH known as vasopressin. Central diabetes insipidus occurs when the hypothalamus cannot produce enough ADH, or the pituitary glands can no longer store and release vasopressin as normal. The abnormal condition causes the kidneys to remove an excessive amount of fluids from the body.
Nephrogenic diabetes insipidus involves the kidneys simply not responding to vasopressin. Your body can make enough ADH, but the kidneys do not respond correctly. This can be a result of inherited gene changes, chronic kidney disease, low potassium or high calcium levels, a blockage of the urinary tract, or certain medications like lithium. The fourth type of diabetes insipidus is known as disogenic. It deals with the thirst mechanism, which is located in the hypothalamus. If the hypothalamus or pituitary is damaged because of surgery, inflammation, infection, a tumor, or other head injuries than you will experience the symptoms of disogenic diabetes insipidus. Medications and mental health may also be related to the rare disorder.
The most common symptom of diabetes insipidus is an increase in thirst. Therefore, you also tend to urinate more than usual. This condition is medically referred to as polyuria. Further, you may also have diluted or clear urine. If you do not quench your thirst or are unable to balance your liquids, then you may become dehydrated. Dehydration or losing too much water will result in weakness or muscle pain. You may also experience irritability or lethargy. Other symptoms of diabetes insipidus include nausea or dizziness, but the primary symptoms are intense thirst and frequent urination.
There are several ways to test your condition. A urine test will reveal if your pee is concentrated and yellow or light and diluted. The latter is a sign of diabetes insipidus. However, a blood test may also be recommended. Keep in mind; this process may take several hours as you might have to go without water to test your thirstiness. Throughout the day, your medical provider can measure the amount of sodium in your urine or blood. Another way to diagnose diabetes insipidus is to see if the kidneys respond properly. This can be done with an ADH substitute. Your doctor will examine both the lab tests and the response to the substitute.
With a constant water loss, your doctor will first suggest drinking plenty of fluids – way more than usual. You should always carry water with you to avoid becoming dehydrated no matter what type of diabetes insipidus you have. Pregnant women diagnosed with gestational diabetes insipidus may not receive any treatment. Your medical provider will monitor your condition closely to see how your body retains fluid. You may be referred to a specialist such as a nephrologist who treats kidney problems. Or an endocrinologist who deals with disorders from hormone-producing glands. Central diabetes insipidus requires medications such as desmopressin. Brand names of these prescriptions are Pitressin and DDAVP. These medications, which usually are available as nasal spray, replace the missing ADH. Desmopressin is the human-made version of vasopressin. The nasal spray might help control urine, manage water from the kidneys, and stop bedwetting.
Nephrogenic diabetes insipidus is treated depending on the cause. Medications can help reduce the symptoms. You and your medical provider can discuss your different options from indomethacin (Indocin) to diuretics such as amiloride (Moduretic) or hydrochlorothiazide (Microzide). There is no effective treatment available for dipsogenic diabetes insipidus. Particular at-home remedies such as sucking on sour candies or ice chips can increase saliva and moisten the mouth. This might help you reduce the urge to drink.
People diagnosed with diabetes insipidus can live a normal life if they follow the medical orders to prevent dehydration. Diabetes insipidus does not lead to dialysis or cause kidney failure. The kidneys can still complete the primary duties to filter the blood. If it is a hot day or you are exercising, make sure you always have something to drink to avoid dehydration.
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