Diabetes Insipidus
Diabetes Insipidus (also known as “water” diabetes) is a rare disorder that causes increased urination. This urine is mostly diluted by water. When the person urinates the urine is usually a clear colour from the water dilution.
Diabetes Insipidus (DI) and Diabetes Mellitus (DM) have most of the same symptoms but are completely different.
Cause(s): There are four different types of DI and each of them have different causes.
- For Pituitary DI (also known as neurogenic DI), it is caused by a lack of hormone that increases the concentration of urine, thus reducing kidney urine output called vasopressin. The lack of vasopressin is caused by the destruction of the back of the pituitary gland, where vasopressin is produced. The destruction can be caused by other diseases such as tumours, infections, head injuries, surgery, brain diseases and other inhereditable defects.
- Gestational DI is caused during pregnancy the pituitary gland can get damaged and/or the Placentia destroys the hormone too rapidly, thus causing DI during pregnancy.
- Nephrogenic DI is caused by the kidneys being unable to respond to the effect of vasopressin. The effects can be caused by drugs or hereditary kidney diseases.
- Dipsogenic DI is caused when vasopressin is suppressed by excessive intake of fluids. This type of DI is hard to differentiate from Pituitary DI. There is an abnormality in the part of the brain that regulates thirst. This is caused by some brain diseases.
Symptoms: Most of the symptoms of DI are similar to Diabetes Mellitus (“sugar” diabetes). They are:
- Increased urination.
- Nocturia (awakens the person to urinate in the night) or enuresis (Involuntarily urinates while the person is asleep. Also known as bedwetting).
- Increased thirst. Most of the urine is water, so the body needs to replenish the lost water.
All the types of DI have the same symptoms, other than Dipsogenic DI, which can also cause lethargy, nausea, headache, and loss of appetite.
Statistics: Every web site I checked said that there was only a hypothesis on how many people have DI in Canada. It is estimated that 4, 800 people in Canada have DI.
Diagnosis: To determine if someone has DI, they test a person’s vasopressin levels. If the person has a low vasopressin production, or none, then they are diagnosed with DI. Excessive thirst and excessive urination also help determine DI.
Treatment and Prognosis: Some of the types of DI cannot be treated and are permanent. Some of them are only temporary (which I will list):
- Pituitary DI is usually permanent and cannot be cured. However, there are various drugs that help control the constant thirst and urination. There is a drug that gives artificial vasopressin known as demopressin or DDAVP.
- Gestational DI can be treated with DDAVP as well, though gestational DI often disappears between 4 to 6 weeks after labour and the medication can be stopped. The symptoms of DI can recur during other pregnancies.
- Nephrogenic DI cannot be treated with DDAVP. Depending on the cause, it may or may not be curable by eliminating the offending drug or disease. The hereditable form is permanent and some of the others may not be curable. There are treatments that can partially relieve the symptoms.
- Dipsogenic DI presently cannot be treated. Nocturia can be relieved by taking small doses of DDAVP.
The prognosis varies depending on if it is treated and depends on the cause of DI.
Prevention / Risk Factors: I could not find any ways to prevent DI.
Extra notes:
- As far as studies show, DI does not reduce life-span
- Excessive urination is considered if an adult urinates more than 50mL/kg body weight per two hours.
- Excessive thirst is someone who drinks more than 12 glasses of water per day, or 4 Litres.
Sources:
http://kidney.niddk.nih.gov/kudiseases/pubs/insipidus/
http://www.diabetesinsipidus.org/
http://www.nlm.nih.gov/medlineplus/ency/article/000377.htm
lol. Mindgames.
I can host for melee if people are willing to GO here.
