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Diabetes Insipidus is a disorder that is characterized by intense thirst and a greatly increased output of diluted urine. In diabetes insipidus you are either producing too little of the antidiuretic hormone (ADH) or it is that your kidneys are not responding normally to the output of ADH. Most people develop diabetes insipidus in early childhood or early adulthood. It is commonly found in more males than females. It has a tendency to develop after surgery, illness or a major head injury.
Urination is frequently increased causing you to crave liquids, especially cold water, in great quantities. If you are unable to keep up with your body's demand for liquids or if an accident or illness prevents you from drinking sufficient quantities, you may become dehydrated. Patients with diabtetes insipidus may need to urinate every 30 minutes to an hour throughout the day and night.
Diabetes insipidus is not related to Diabetes Mellitus (which is the bodies inability to regulate insulin). In Diabetes Mellitus the body has trouble using insulin to turn sugar into energy.
Reasons to suspect diabetes insipidus:
Increased frequency of urination.
Insatiable thirst.
Increased fluid intake.
Diluted urine.
Increased urine output.
Dehydration.
Increased heart rate.
Low blood pressure.
Dry mouth.
Sunken appearance to the eyes.
Lack of tears or inability to sweat.
Poor skin elasticity.
Sudden weight loss.
Unexplained weakness.
Confusion or irritability.
There are two main types of diabetes insipidus: central or neurogenic (related to the nervous system) and nephrogenic (related to the kidneys). With Central diabetes insipidus the hypothalmus (a part of the brain that controls the endocrine system) does not produce enough ADH. This will sometimes cause other conditions, that may include:
Tumors that affect the hypothalmus or pituitary glands.
Tumors that form bumps on the tissues organs.
A rare inherited syndrome called Wolfman syndrome.
Brain injuries due to hypertension.
Uterine bleeding.
Pregancy complications or Sheehans syndrome.
And in some cases acquired immune deficiency syndrome.
Many childhood cases of diabetes insipidus have no underlying causes.
With Nephrogenic diabetes there is enough ADH produced, but the kidneys don't respond sufficiently. Causes of nephrogenic diabetes have included:
Kidney injury (due to infections of the pelvis and kidney tissues).
Myeloma (a build up of a waxy protein in the organs and tissues).
Sj'grens syndrome (an abnormal dryness of mucus membranes).
Excess calcium or low potassium in the blood.
Cysts in the liver or kidneys.
In some cases those taking lithium for extended periods of time have develope diabetes insipidus also. Nephrogenic diabetes has also been found to be inherited.
Doctors usually suspect diabetes insipidus when the patient complains of increased thirst and frequent urination. The first diagnotic test is a collection of urine for a 24 hour period. In most cases it will be very diluted. You may need other tests to confirm the diagnosis. A doctor may perform a water-deprivation test (to see how your body responds to dehydration) or a vasopressin challenge (to see how your body responds to synthetic ADH). Once diabetes insipidus is diagnosed the cause must be determined. An MRI may also be performed to see if the regions of your brain that pituitary and hypothalmus appear normal.
Medications that are used to treat diabetes insipidus include, pitressin, desmopressin acetate, chlorpropamide, clofibrate and carbamazepine. If you have diabetes insipidus, you may need to take a diuretic and eat a low-sodium diet. Cases of this type of diabetes caused by injury, pregnancy or surgery have sometimes resolved themselves. If this is not the case you may need lifelong treatment.
Besides taking precautions to prevent brain and kidney injury there is no way to actively ward off diabetes insipidus. If you exhibit any of the above symptoms either after pregnancy, injury or surgery tell your doctor immediately. When dealing with children that show these signs make sure that a pediatric internist is consulted.
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