Diabetes insipidus: is it the same as diabetes? Know the symptoms of this rare condition

Diabetes insipidus is an uncommon condition that causes frequent urination and thirst as the body loses its ability to concentrate urine, leading to large losses of fluids throughout the day and increasing the risk of dehydration. Diabetes insipidus is not the same as diabetes mellitus and has nothing to do with your blood sugar levels. However, some symptoms of diabetes insipidus and diabetes mellitus can be common. (Also read: Diabetes: Signs of Low Blood Sugar)

Diabetes insipidus occurs because of problems with a hormone called vasopressin, which helps the kidneys maintain fluid balance. It can also be due to a malfunction of a part of the brain that controls thirst, or can also occur transiently during pregnancy when the mother’s placenta NIH external junction produces too much of an enzyme that breaks down her vasopressin.

“Normal kidneys are able to produce concentrated urine because of a hormone called vasopressin. When the body loses its ability to concentrate urine, either due to a lack of this hormone or lack of sensitivity to it, large amounts of dilute urine are produced, resulting in >3 L of fluid loss from the body per day. The concentration of normal urine is 800-1200 mOsmol/L, but in the case of diabetes insipidus, the urine concentration falls below 300 mOsmol/L, resulting in large urine losses per day. says dr Anurag Aggarwal, Senior Consultant, Internal Medicine, Marengo QRG Hospital.

Diabetes insipidus should not be confused with psychogenic polydypsy, in which a person voluntarily ingests large amounts of pure water, causing them to urinate large amounts of urine.

TYPES OF DIABETES INSIPIDUS

according to dr Anupam Biswas, Specialist in Endocrinology, Fortis Hospital, Noida, there are 4 types of diabetes insipidus.

1. Central DI – damage to the pituitary or hypothalamus from head injury/surgery/tumor – occurs due to a lack of ADH (antidiuretic hormone).

2. Nephrogenic DI – inability of the kidney to concentrate urine in response to ADH due to hereditary or acquired causes.

3. Dipsogenic DI – due to excessive fluid intake.

4. Pregnancy-related DI – A muscular substance of the placenta that prevents the mother’s ADH from functioning properly.

SYMPTOMS OF DIABETES INSIPIDUS

Symptoms of Diabetes Insipidus According to Dr. Anurag Aggarwal and Dr. Anupam Biswas are:

1. Polyuria – the patient urinates profusely, ranging from 3-20 L/day.

2. Polydypsia – due to the excessive loss of large amounts of diluted urine, the patient experiences excessive thirst. due to increasing the concentration of solutes in the body and to replenish lost fluids.

3. Nocturia – Patient gets frequent urge to urinate, even before bedtime and at night.

4. Irritability and fatigue.

5. Headache or visual disturbances in case of pituitary tumor.

6. In children, bedwetting is one of the symptoms.

DIAGNOSIS

dr Aggarwal says the following lab tests help diagnose diabetes insipidus.

1. A 24-hour urine collection to determine urine volume

2. Serum electrolyte concentrations and glucose levels

3. Simultaneous plasma and urine osmolality

4. Plasma ADH levels

5. Specific Gravity of Urine

6. Tests of the pituitary gland, including magnetic resonance imaging (MRI) and measurement of circulating pituitary hormones other than ADH

TREATMENT

Most patients are able to replace the lost fluid by drinking plenty of fluids, but in the case of reduced oral fluid intake and when hypernatremia, i.e. increased sodium concentration in the blood, occurs, the following measures are taken:

– Dextrose and water or an intravenous fluid that is less concentrated compared to the patient’s serum.

– Administer fluids at 500–750 ml/h; Lower serum sodium by approximately 0.5 mmol/L (0.5 mEq/L) per hour.

– desmopressin

– Synthetic vasopressin

– Chlorpropamide

– Carbamazepine

– Thiazide diuretics

– NSAIDS such as indomethacin (used when nothing else is available)

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