Diabetes insipidus

Are you constantly thirsty and making frequent trips to the bathroom, even when you haven’t been drinking extra fluids? These symptoms can have several causes. But producing unusually large amounts of pale urine along with intense thirst may be a sign of diabetes insipidus.

At Diabetes & Glandular Disease Clinic, we diagnose and treat diabetes insipidus for patients throughout San Antonio.

Diabetes insipidus (DI) is a disorder that affects the body’s ability to balance water. A hormone called arginine vasopressin, also known as antidiuretic hormone (ADH), tells the kidneys to conserve water when the body needs it.

Diabetes insipidus develops when the body doesn’t make or release enough vasopressin. It can also happen when the kidneys don’t respond to it properly. Without this signal, the kidneys release too much water into the urine.

No. Diabetes insipidus is a different condition from diabetes mellitus, the disease associated with high blood sugar. Although both conditions can cause increased thirst and frequent urination, they have different causes and treatments. Diabetes insipidus does not cause high blood sugar.

People with DI are extremely thirsty and produce unusually large amounts of urine. Other signs and symptoms include:

• Pale or nearly clear urine
• Being extremely thirsty
• Waking repeatedly to urinate and drink
• Bed-wetting or a new increase in nighttime urination
• Interrupted sleep from frequent trips to the bathroom
• Trouble staying hydrated

The cause of diabetes insipidus depends on which part of the body’s water-control system is affected.

Central Diabetes Insipidus

Central diabetes insipidus develops when the brain doesn’t make or release enough vasopressin. It may be inherited or develop after:

• Brain or pituitary surgery
• A head injury
• Infection
• Inflammation
• A tumor affecting the hypothalamus or pituitary gland

This type is also called arginine vasopressin deficiency (AVP-D).

Nephrogenic Diabetes Insipidus

In nephrogenic diabetes insipidus, the body produces vasopressin, but the kidneys don’t respond to it normally. This can happen because of:

• Chronic kidney disease
• High calcium levels
• Low potassium levels
• A urinary tract blockage
• Certain medications, such as lithium

This type is also called arginine vasopressin resistance (AVP-R).

Gestational Diabetes Insipidus

Gestational diabetes insipidus develops during pregnancy because the body breaks down vasopressin too quickly. Symptoms usually improve after delivery, but the condition may return during a future pregnancy.

Your doctor will begin by reviewing your symptoms, fluid intake, medications, and medical history. Tests may include:

• A urinalysis to measure urine concentration and check for glucose
• Blood tests to measure sodium, glucose, calcium, potassium, and kidney function
• Measurement of urine output
• A medically supervised water-deprivation test
• Testing your response to desmopressin or vasopressin
• An MRI of the pituitary gland and surrounding structures

Treatment depends on which type of diabetes insipidus you have and what’s causing it.

Central Diabetes Insipidus

Central DI is usually treated with desmopressin, a manufactured form of vasopressin. It may be given as a tablet, nasal spray, or injection. Your doctor will carefully adjust the dose and recommend the appropriate amount of fluid. Taking too much desmopressin can cause the body to retain excess water.

Nephrogenic Diabetes Insipidus

Depending on the cause, treatment may include:

• Correcting high calcium or low potassium levels
• Treating a urinary tract blockage
• Changing medications that may be contributing under medical supervision

Your doctor may also recommend reducing dietary salt or prescribing a thiazide diuretic to decrease urine production. Taking a water pill may seem surprising when you’re already urinating frequently. But it can actually reduce the amount of urine your body produces.

Gestational Diabetes Insipidus

Gestational diabetes insipidus is usually treated with desmopressin and monitored throughout pregnancy.

If you’re urinating much more than usual, feeling unusually thirsty, or having trouble staying hydrated, don’t ignore your symptoms. The biggest immediate concern with diabetes insipidus is dehydration. It can raise the sodium level in your blood and lead to serious complications.

At Diabetes & Glandular Disease Clinic, our endocrinologists diagnose the cause of your symptoms and develop a treatment plan to help you manage diabetes insipidus and prevent complications. Contact us today to schedule an evaluation.

1. How can I tell diabetes insipidus from an overactive bladder?

Overactive bladder causes sudden urgency and frequent bathroom trips, often with only a small amount of urine. Diabetes insipidus causes the body to produce large amounts of very diluted urine along with intense thirst.

2. Can diabetes insipidus be cured?

Gestational diabetes insipidus usually improves after delivery. Temporary cases caused by surgery, an injury, certain medications, or electrolyte problems may also improve once the underlying cause is treated. Other forms typically require ongoing treatment to control thirst, urine production, and fluid balance.

3. Is diabetes insipidus serious?

Diabetes insipidus can become serious if it isn’t treated because the body loses too much water. Without enough fluids, dehydration can develop and sodium levels in the blood can become dangerously high. With the right treatment and careful management, most people with diabetes insipidus can control their symptoms and avoid complications.