Treatment of Diabetes Insipidus
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Despite the similar name, diabetes insipidus is not diabetes and has different symptoms. Diabetes insipidus develops if the pituitary gland or hypothalamus, which are both responsible for the process of hydration in the body, fail to function properly. Water that would normally pass through a person’s body and be mixed with waste products in the kidneys to make urine now passes straight through.
The body of a healthy person is made up of 60% water. With diabetes insipidus, the percentage of fluid in the body becomes much lower. As a result, the sufferer of diabetes insipidus constantly feels thirsty. However, since the kidneys are unable to retain the required amount of water, even drinking 6-7 litres a day will not quench the sufferer’s thirst but they will need to urinate frequently. Urine in this case is odorless and heavily diluted.
There are four types of diabetes insipidus: central, nephrogenic, dipsogenic and gestational:
Central diabetes insipidus develops if the hypothalamus has been damaged or if the pituitary gland is unable to produce the necessary hormones. This type of diabetes insipidus accounts for almost 70% of all cases of this disease. It can be caused by head trauma, surgery or an abnormal supply of blood to the pituitary gland.
Nephrogenic diabetes insipidus develops if there is a congenital problem with the kidneys.
Dipsogenic diabetes insipidus is caused by a dysfunction of the body’s thirst mechanism.
Gestational diabetes insipidus can occur during pregnancy if the placenta destroys the mother’s antidiuretic hormone (ADH).
- Constant thirst
- Extremely frequent need to urinate
- Bedwetting
- Fever
- Dry skin
- Dehydration
- Fatigue
- Irritation
- Urinalysis measures the concentration of water in the urine. If it is very high, this can indicate that the patient has diabetes insipidus. A low concentration of waste products in the urine is also another indicator of this condition.
- An MRI scan is performed to examine the hypothalamus and helps doctors to determine whether there is a problem with it.
- A doctor may ask the patient to deprive themselves of water for a short period of time, to see how their body responds to it.
- Conservative treatment usually includes hormone therapy, which helps the kidneys to process water normally again. Most commonly, patients are prescribed desmopressin hormone, which assists the pituitary gland.
- Surgery is only recommended if diabetes insipidus was caused by a malfunction of the pituitary gland or hypothalamus. Sometimes, the hypothalamus is not able to work properly if there an adenoma (benigh tumour) has developed there. In this case, the adenoma would need to be resected.
Overall, treatment for diabetes insipidus is favorable if started soon after diagnosis.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
