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Common Name:

Diabetes Insipidus

Medical Term:

Description:

A rare disorder, resulting in excessive thirst and excessive passage of very dilute urine, due to a hormone deficiency in the pituitary gland, which is situated at the base of the brain.

 Diabetes Insipidus results from a decreased production of  antidiuretic hormone ( vasopressin) , the hormone that normally prevents the kidney from producing too much urine.

Antidiuretic hormone is produced in the hypothalamus, then stored  and released in the blood stream by the posterior pituitary. Diabetes insipidus  may also occur with normal levels of antidiuretic  hormone, when the kidneys do not respond normally to the hormone. This condition is called  nephrogenic diabetes insipidus.

 

Causes: Diabetes Insipidus may have several causes which are as follows:   Tumor of the pituitary gland; Head injury, with damage to pituitary gland; Brain tumor; Infections, such as meningitis or encephalitis; Hemorrhage in the pituitary gland or in adjacent structures; Aneurysms; Kidney disease; Sarcoidosis.

 

Prevention: No specific preventive measures.

 

Signs & Symptoms

 Excessive thirst that is difficult to satisfy.

Passage of large amounts (up to 15 quarts a day) of diluted, colorless urine.
Dehydration, leading to rapid heart rate, low blood pressure and shock.
 Constipation.
Mild cases may present with unremitting enuresis (bed-wetting).
Risk Factors

Brain tumor or pituitary gland tumor.

Head Injury
Infections such as meningitis, encephalitis, tuberculosis.
Sarcoidosis
Family history of diabetes insipidus.
 Atherosclerosis (hardening of the arteries).
Diagnosis & Treatment
Diabetes Insipidus is suspected when a patient presents with a history of excessive thirst  and passing large amounts of urine (polyuria). Diabetes insipidus should be distinguished from diabetes mellitus by testing the urine for sugar. There is no single laboratory test to make a diagnosis of diabetes insipidus.

Evaluation of diabetes insipidus should include a 24-hour urine collection for volume, glucose and creatinine. 

If diabetes insipidus is suspected ,  water-deprivation test to determine levels of ADH (antidiuretic hormone)  may be done. However, this test has to be done in a hospital setting. 

General Measures:
Treatment involves controlling fluid balance and preventing dehydration; and identifying and eliminating the cause of the diabetes insipidus.
Check weight daily and maintain a record.
Wear a medical identification bracelet or neck pendant that indicates your medical problem and the medications you take.
Medications:
Vasopressin or desmopressin acetate, modified  synthetic forms of antidiuretic hormone, may be taken as a nasal spray several times a day, to maintain a normal urine output. However, taking too much of this medication can cause fluid retention and swelling and other problems.
Sometimes diabetes insipidus can be controlled with drugs that stimulate  production of antidiuretic hormone such as chlorpropamide, carbamazepine, clofibrate.
Activity:

No restrictions. 

Diet:
No special diet. Drink as much water as you feel you need.
Possible Complications :

Electrolyte imbalance, especially low sodium or potassium deficiency. Either of these can cause heartbeat irregularity, fatigue and congestive heart failure.

 
Severe dehydration
Prognosis

The prognosis is generally good depending on the underlying disorder.

Other

 'Nothing Specified'.

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