Diabetes insipidus is a rare medical condition characterized by an imbalance of body fluids, leading to the excretion of large amounts of diluted urine and a feeling of constant, intense thirst. 

What is diabetes insipidus?

Diabetes insipidus Diabetes Insipidus, which is also known as urinary insipidus, is a disorder resulting from a lack of secretion or a defect in the functioning of a hormone. Vasopressin (Vasopressin), known as antidiuretic hormone (ADH)Or the kidneys do not respond to this hormone. 

When a decrease in the hormone level occurs or the kidneys lose their ability to respond to it, the body loses its ability to retain sufficient amounts of water, so it excretes large amounts of diluted (poorly concentrated) urine, and the patient feels a constant thirst to compensate for the lost fluids.

 The disease is called “diabetes insipidus” because of some similarity in symptoms to true diabetes (frequent urination and thirst), but it is considered insipidus because the urine in this case is free of sugar and the cause of the disease is related to fluid regulation only.

Types of diabetes insipidus

It is divided into two main types according to the origin of the hormonal imbalance:

ا. السكري الكاذب المركزي

 Also called neuritic diabetes insipidus; a result:

•  Damage to the brain, such as a severe head injury or surgery.
•  A tumor near the pituitary gland.
•  Infections.
•  Genetic causes.
•  Sometimes it may be of unknown cause.

for.

 In this type, the level of ADH is normal or high, but the kidneys do not respond to it properly. It may happen That's because:

•  A genetic defect that affects hormone receptors or the structure of the kidneys.
• Chronic kidney disease and kidney damage resulting from infections.
• A side effect of taking some medications for long periods (most notably medication Lithium Used for some psychological disorders).

There too Two types Less common than that They are:

• Gestational diabetes insipidus:
  A rare condition that occurs only during pregnancy, where the placenta secretes enzymes that break down the mother's ADH hormone, especially in the last months of pregnancy, which causes symptoms of diabetes insipidus temporarily and then things return to normal after birth.

• Primary polydipsia (diabetes mellitus):
  A condition in which the cause is excessive drinking of water (motivated by constant, abnormal thirst), either due to a defect in the thirst center in the brain or psychological reasons.

Treatment of renal diabetes insipidus

Since the problem with this type is that the kidneys do not respond to the hormone, giving desmopressin will not help much. 

This includes a low-salt diet (to reduce diuresis). Thiazide In small doses, it has been found that this drug helps reduce diuresis in patients with renal type.
It is also necessary to address any correctable cause that led to the condition;

Special cases: In the type of disease resulting from pregnancy, treatment is also with the hormone desmopressin, which is effective and safe for pregnant women, and the condition resolves after childbirth. Primary polydipsia (Drinking too much water psychologically). There is no role for hormonal treatment. Rather, the solution lies in gradually reducing water drinking to normal limits and treating the underlying psychological problem with the help of a specialist if necessary.

What are the symptoms of diabetes insipidus?

  They are all related to fluid loss and the body's lack of water retention, including the following:

• Constant intense thirst: The patient feels constant dryness in the mouth and throat and an unrelenting desire to drink large quantities of water, after which the feeling of thirst continues.
• Frequent urination and the secretion of large amounts of urine: The patient excretes urine that is much more than the normal limit in quantity, and the urine is transparent or very pale in color because it is diluted and low in concentration.
• Signs of dehydrationContinuous fluid loss leads to symptoms of dehydration in the body if it is not adequately compensated.

In addition to the above, parents may notice some signs in infants and young children with this disease, such as: more wet diapers than usual or frequent involuntary urination at night, excessive thirst, and constant crying for fluids.

Read also: What is an insulin resistance test?.

The difference between diabetes and diabetes insipidus

Although the names are similar to true (urinary) diabetes and some of the symptoms (thirst and frequent urination), However, the two cases are fundamentally different Next:

• In terms of cause and disease mechanism: True diabetes (Diabetes Mellitus) occurs due to a defect in... Insulin hormone It leads to a chronic rise in blood glucose levels and its excretion in the urine.

• In terms of symptoms and complications: In true diabetes, other symptoms appear in addition to thirst and frequent urination, such as extreme hunger or weight loss (especially in type 1), and chronic complications may occur in the long term, such as neuropathy, poor vision, and kidney disease, if not treated appropriately.

How do I know if I have diabetes insipidus?

The diagnosis of this disease depends on a group of tests that confirm the loss of urine concentration and determine the cause of the problem. One of the most prominent tests used for diagnosis the following :

• Urinalysis: The urine appears very dilute (very low density) and free of sugar or proteins.
• Analysis of sodium levels in the blood: which may be high in this case due to fluid deficiency.
• Kidney function tests: Kidney functions are also checked to ensure their safety.
• Water deprivation testIt is the most important diagnostic test and is performed under medical supervision by preventing the patient from drinking any liquids for several hours while monitoring his weight and measuring the amount and concentration of urine periodically.
• التصوير بالرنين المغناطيسي (MRI): An imaging of the brain (especially the pituitary gland and hypothalamus) is performed to look for any structural abnormalities such as tumors or injuries that may be the cause of central diabetes insipidus.

These tests are available in advanced medical laboratories at Al Mousa Hospitals to accurately perform the necessary analyzes. Advanced imaging techniques such as MRI are also available to help diagnose this condition and determine the cause accurately.

Also learn about: Diabetes and Endocrine Treatment Center 

Can diabetes insipidus be cured?

Most chronic conditions cannot be completely cured, but treatment can effectively control symptoms and prevent complications. One of the ways to control symptoms التالى :

1. Drink plenty of water:
   Replacing lost fluids is always the key step.

1. Treatment of central diabetes insipidus:
   The main line of treatment is to replace the lost ADH using a synthetic hormone replacement (Desmopressin), which is available in the form of nasal spray, oral tablets, or injections.

If there is a specific reason that led to the hormone deficiency (such as a brain tumor), it is also treated with surgery or medications as required by the case.

Cases that require going to the emergency room

Although most patients can control the disease and avoid serious complications if they adhere to treatment and drink enough water, there are still some emergency circumstances that require an immediate trip to the emergency department. وأهمها:

1. Signs of severe dehydration appear: Such as severe dizziness, mental confusion or fainting.
2. Inability to replace fluids: Such as persistent vomiting or diarrhea that prevents the patient from drinking a sufficient amount of water, which exposes him to the risk of rapid dehydration.
3. The occurrence of serious neurological symptoms: Such as convulsions or loss of consciousness.
4. Severe dehydration in infants or children: Such as lack of wetness of the diaper for long periods or crying without tears, with apparent lethargy in the child.

In an emergency, doctors will replace lost fluids intravenously and correct the electrolyte imbalance urgently, while treating the cause that aggravated the condition. 

Note that the emergency department at Al Mousa Hospitals Group is equipped to quickly deal with cases of severe dehydration and electrical imbalances in patients.

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Living with the disease and an appropriate lifestyle

Following some daily procedures helps control the symptoms of the disease and prevent complications. The most important advice from doctors to live with اFor a case التالي:

• Commitment to treatment and medical follow-up:
  Prescribed medications (such as desmopressin) must be taken regularly according to the doctor’s instructions, while ensuring periodic examinations and continuous follow-up to ensure the effectiveness of the treatment plan.

• Provides water permanently:
  The patient should carry a bottle of water with him wherever he goes. Keeping the body constantly hydrated prevents dehydration and replaces fluid losses as soon as possible.

• Diet modification:
  It is recommended to reduce salt consumption in food to reduce diuresis, and avoid excessive intake of proteins.

• Planning daily activities:
  The patient should take his condition into consideration when undertaking any activity or travel.

Frequently asked questions

Does diabetes insipidus affect a woman's fertility or ability to get pregnant?

 This disease does not usually affect a woman's fertility, and she can get pregnant normally, but she needs careful monitoring during pregnancy to avoid dehydration and electrolyte imbalance, especially in the last trimester.

Can a patient with diabetes insipidus fast safely (such as fasting during Ramadan) without exposing himself to dehydration?

The patient can fast if his condition is stable and under medical supervision, while making sure to drink sufficient amounts of water between breakfast and suhoor to avoid dehydration and electrolyte imbalance.

What are the possible long-term complications of diabetes insipidus?

The disease does not cause direct damage to the kidneys or organs if it is controlled, but neglecting it may lead to chronic dehydration, high blood sodium, and disturbances in fluid balance.

Is diabetes insipidus a hereditary disease?

Yes;

And conclusion: Diabetes insipidus may seem like a mysterious disease, but it is completely controllable with early diagnosis and proper treatment. مستشفيات الموسىThe patient can live a normal life free of anxiety or complications. 

Do not hesitate to contact us to book your consultation with one of our specialized doctors to ensure an accurate evaluation and integrated medical care that suits your condition.

You may be interested in: Digestive Diseases Center