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Diabetes insipidus (DI), also called water diabetes, is a condition marked by increased thirst and urination. It is not to be confused with the more common type of diabetes, diabetes mellitus (sugar diabetes). Four underlying conditions can lead to DI.
Maintaining proper water balance by drinking enough fluids is critical for children with DI, as they tend to lose a lot of water with frequent urination, which can lead to life-threatening dehydration. However, drinking too much water is also dangerous, as it may lead to a rare condition called water intoxication. Symptoms
DiagnosisDefinitive diagnosis is most often made with:
When to Call for HelpIf you see any of the above symptoms in your child or teen, call your pediatrician. Increased urination and odorless, pale urine should always be red flags as they may signal water imbalance. Children with DI are also at an increased risk for dehydration if they don’t replenish the loss of water, so they need to be observed for signs of dehydration, such as dry mouth, sluggishness, muscle weakness, dizziness, few or no tears when crying, rapid heart beat, fever, lack of sweating and extreme thirst. TreatmentMedications that deliver synthetic vasopressin are the therapy for central DI. For nephrogenic DI, water pills (diuretics) are used.
Diabetes insipidus is characterised by extreme thirst and the passing of vast amounts of urine. It is caused by insufficient vasopressin, a hormone produced by the brain that instructs the kidneys to retain water. Without enough vasopressin, too much water is lost from the body in urine, which prompts the affected person to drink large amounts of fluids in an attempt to maintain their fluid levels. In severe cases, a person may pass up to 30 litres of urine per day. Without treatment, diabetes insipidus can cause dehydration and, eventually, coma due to concentration of salts in the blood, particularly sodium. The name of this condition is a little misleading, since diabetes insipidus has nothing to do with diabetes mellitus (a condition characterised by high blood sugar levels), apart from the symptoms of thirst and passing large volumes of urine. The word diabetes means 'to go through' - describing the excessive urination. Insipidus means the urine is tasteless, whereas mellitus suggests it is sweet from its sugar content. This terminology dates back to a time when physicians literally dipped a finger in the patient's urine and tested its taste. Not a diagnostic method much in use today! SymptomsThe symptoms of diabetes insipidus include:
Too much water is lost in the urineThe kidneys are organs of excretion. They filter the blood to remove wastes (such as urea) and regulate the amount of salts and water in the bloodstream. The hormone vasopressin is made by a structure in the brain called the hypothalamus. Vasopressin controls the amount of water excreted by the kidneys. Diabetes insipidus can be caused by two flaws in this process: the hypothalamus isn't making enough vasopressin or the kidneys aren't responding to the hormone. Either way, the result is the loss of too much water in the urine, leading to the characteristic symptom of excessive thirst. There are various forms of diabetes insipidusThe forms of diabetes insipidus are categorised by cause and include:
Possible complicationsWithout medical treatment, the possible complications of diabetes insipidus include:
Diagnosis methodsDiabetes insipidus is diagnosed using a number of tests including:
Treatment optionsTreatment for diabetes insipidus (DI) depends on the cause. For DI that is associated with decreased vasopressin production, replacement of vasopressin is required. This is usually given by sniffing a small amount of vasopressin that can be absorbed through the lining of the nose. For DI that is associated with reduced or absent response to vasopressin, adequate replacement of fluids is necessary.
Some forms of DI, such as those that occur following head injury or neurosurgery or during pregnancy, resolve with time. Where to get help
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This page has been produced in consultation with and approved by:
This page has been produced in consultation with and approved by:
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