Diabetes insipidus

Not to be confused with diabetes mellitus, commonly shortened to diabetes.
Diabetes insipidus
Vasopressin
Pronunciation
SpecialtyEndocrinology
SymptomsLarge amounts of dilute urine, increased thirst[1]
ComplicationsDehydration, seizures[1]
Usual onsetAny age[2][3]
Types
CausesDepends on the type[1]
Diagnostic methodUrine tests, blood tests, fluid deprivation test[1]
Differential diagnosisDiabetes mellitus[1]
TreatmentDrinking sufficient fluids[1]
MedicationDesmopressin, thiazides, aspirin[1]
PrognosisGood with treatment[1]
Frequency3 per 100,000 per year[4]

Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst.[1] The amount of urine produced can be nearly 20 liters per day.[1] Reduction of fluid has little effect on the concentration of the urine.[1] Complications may include dehydration or seizures.[1]

There are four types of DI, each with a different set of causes.[1]

  1. Central DI (CDI), also known as arginine vasopressin deficiency (AVP-D),[5] is due to a lack of vasopressin (antidiuretic hormone) production.[1] This can be due to injury to the hypothalamus or pituitary gland or due to genetics.[1]
  2. Nephrogenic DI (NDI), also known as arginine vasopressin resistance (AVP-R),[5] occurs when the kidneys do not respond properly to vasopressin.[1]
  3. Dipsogenic DI is a result of excessive fluid intake due to damage to the hypothalamic thirst mechanism.[1] It occurs more often in those with certain psychiatric disorders or on certain medications.[1]
  4. Gestational DI occurs only during pregnancy.[1]

Diagnosis is often based on urine tests, blood tests and the fluid deprivation test.[1] Despite the name, diabetes insipidus is unrelated to diabetes mellitus and the conditions have a distinct mechanism, though both can result in the production of large amounts of urine.[1]

Treatment involves drinking sufficient fluids to prevent dehydration.[1] Other treatments depend on the type.[1] In central and gestational DI, treatment is with desmopressin.[1] Nephrogenic DI may be treated by addressing the underlying cause or by the use of a thiazide, aspirin or ibuprofen.[1] The number of new cases of diabetes insipidus each year is 3 in 100,000.[4] Central DI usually starts between the ages of 10 and 20 and occurs in males and females equally.[2] Nephrogenic DI can begin at any age.[3] The term "diabetes" is derived from the Greek word meaning siphon.[6]

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z "Diabetes Insipidus". National Institute of Diabetes and Digestive and Kidney Diseases. October 2015. Archived from the original on 13 May 2017. Retrieved 28 May 2017.
  2. ^ a b "Central Diabetes Insipidus". NORD (National Organization for Rare Disorders). 2015. Archived from the original on 21 February 2017. Retrieved 28 May 2017.
  3. ^ a b "Nephrogenic Diabetes Insipidus". NORD (National Organization for Rare Disorders). 2016. Archived from the original on 19 February 2017. Retrieved 28 May 2017.
  4. ^ a b Saborio P, Tipton GA, Chan JC (2000). "Diabetes Insipidus". Pediatrics in Review. 21 (4): 122–129. doi:10.1542/pir.21-4-122. PMID 10756175. S2CID 28020447.
  5. ^ a b Arima, Hiroshi; Bichet, Daniel G.; Cheetham, Timothy; Christ-Crain, Mirjam; Drummond, Juliana; Gurnell, Mark; Levy, Miles; McCormack, Ann; Newell-Price, John; Verbalis, Joseph G.; Wass, John; Cooper, Deborah (2022-12-01). "Changing the name of diabetes insipidus". Pituitary. 25 (6): 777–779. doi:10.1007/s11102-022-01276-2. ISSN 1573-7403. PMID 36334185. S2CID 253350878.
  6. ^ Rubin AL (2011). Diabetes For Dummies (3 ed.). John Wiley & Sons. p. 19. ISBN 9781118052488. Archived from the original on 2017-09-08.