DIABETES INSIPIDUS

TYPES

The different types of diabetes insipidus include:

• Central DI. It is caused by a tumor, head injury, or illness that damages the pituitary gland, affecting the production, storage, and release of ADH.
• Nephrogenic DI. It is caused by a defect in the kidney tubules that makes it unable to respond properly to ADH. It can also be caused by an inherited genetic disease, kidney disease, or intake of particular drugs such as antiviral medications.
• Gestational DI. This occurs during pregnancy when an enzyme in the placenta attacks the ADH of the mother.
• Dipsogenic DI/Primary Polydipsia. It is caused by drinking excessive amounts of fluids that result in huge amounts of diluted urine. It can also be caused by damages in the hypothalamus that affects thirst-regulation.

SYMPTOMS

• Extreme thirst
• Preference for cold drinks
• Excessive urination: urine output may go up to 19 liters/day (1 to 2 liters is the average). You may also frequently urinate during the night.

DIAGNOSIS

The patient will undergo a water deprivation test wherein fluid intake will be stopped for several hours. The doctor will examine for body weight, urine output, and urine concentration in the blood. ADH blood levels may also be measured.

An MRI scan may also be performed to inspect the pituitary gland.

TREATMENT

The treatment varies per type of diabetes insipidus.

For Central DI:

• Increased water intake for mild cases
• Treatment on the pituitary gland if an abnormality is an underlying cause
• Taking desmopressin
• Medications such as indomethacin and chlorpropamide

For Nephrogenic DI:

• Low-salt diet and drinking enough water
• Stopping the use of medications that can cause the condition

For Gestational DI:

• Using synthetic hormone desmopressin

For Dipsogenic DI:

• Decreasing fluid intake
• Treating mental illness if it is the underlying cause