Pronounced: diabetes -in-' sip-d-s
There are two forms of diabetes insipidus (DI):
Central diabetes insipidus (Central DI)—caused by inadequate antidiuretic hormone (ADH) Nephrogenic diabetes insipidus (NDI)—due to renal cells in the kidneys not responding to ADH
ADH controls the amount of water reabsorbed by the kidneys. ADH is made in the
of the brain. The
, at the base of the brain, stores and releases ADH.
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(up to 50% of cases, the cause is unknown) may be caused by:
A lack of ADH made in the brain due to a genetic defect Damage to the hypothalamus or pituitary glands by surgery, infection, tumor, or head injury
Sickle cell disease
may be caused by:
The following factors increase your chance of developing diabetes insipidus:
Damage to the hypothalamus due to surgery, infection, tumor, or head injury Polycystic kidney disease or another kidney disease that may affect the filtration process Use of certain medications such as lithium, amphotericin B, or demeclocycline High blood levels of calcium Low blood levels of potassium
If you have any of these, do not assume it is due to diabetes insipidus. These symptoms may be caused by other health conditions. See your doctor, if you experience any one of them:
Extreme thirst with preference for cold drinks in central DI Muscle weakness Headache Fever Blurred vision Low blood pressure Rapid pulse Frequent urination, especially during the night (nocturia) Dehydration
Your doctor will ask about your symptoms and medical history. A physical exam may be done.
Tests may include the following:
Electrolytes ADH levels Blood sugar
Urine specific gravity and/or osmolality (measures how concentrated or dilute the urine is)
Water deprivation test
Only done under doctor supervision Urine output is measured for a 24-hour period Diabetes insipidus can cause as much as 4-10 liters of urine to be excreted per day Central DI—urine output
is suppressed by a dose of vasopressin/ADH NDI—urine output
suppressed by a dose of vasopressin/ADH
Magnetic resonance imaging (MRI)
of the head—if CDI is suspected
Talk with your doctor about the best plan for you. Treatment options include the following:
A synthetic form of ADH—this drug could be taken by mouth, inhaled through the nose, or by injection Diuretic “water pill” or an antidiabetic medication—in mild cases to boost the ADH effect on the renal cells in the kidney
A diuretic “water pill” could be used If lithium is causing the problem—another diuretic, amiloride, could be used
In both CDI and NDI, symptoms can often be reduced by:
Decreasing the amount of sodium in the diet Medication called thiazide diuretics (diuretics they conserve water loss and decrease urine output in people with diabetes insipidus)
There are no known ways to prevent diabetes insipidus. It is wise to seek medical attention promptly if you excessive urination and thirst.
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. Accessed September 20, 2005.
Diabetes insipidus. MedlinePlus Medical Encyclopedia website. Available at:
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The Merck Manual of Diagnosis and Therapy
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Pediatr Endocrinol Rev
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Last reviewed January 2009 by
Rosalyn Carson-DeW¹itt, MD
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
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