Simple diabetes insipidus – causes, symptoms, treatment

Proven content

Diabetes insipidus is a condition caused by a shortage of a hormone called vasopressin produced by the posterior pituitary gland, which causes the urine to condense and pass it out regularly. The symptoms of diabetes insipidus are interrelated: a constant feeling of thirst occurs together with the frequency and amount of urine you pass.

Simple diabetes insipidus – definition

Diabetes insipidus is an endocrine condition caused by a deficiency or disturbance of vasopressin secretion by the posterior pituitary gland. Vasopressin is a hormone that affects the collecting tubules of the kidneys, thickens the urine and systematically excretes it from the body. The patient then experiences a constant thirst and consequently drinks a lot of water. At some point, the patient notices that taking too much fluid causes a constant urge to urinate, so the amount of it is reduced. Unfortunately, this does not change anything, the need to urinate remains the same, and the patient feels signs of dehydration, which is very dangerous. A healthy person excretes 1,5-2,5 liters of urine per day, while people suffering from diabetes insipidus excrete up to 15 liters of urine (most at night).

Simple diabetes insipidus – causes

The causes of diabetes insipidus are found in disturbances in the level of vasopressin, which regulates kidney function. If we drink enough fluids, the body excretes excess fluid in the urine, if there is not enough fluid in the body, urine becomes concentrated – all these reactions are controlled by vasopressin. If there is a disturbance in its production, the body’s water balance is also disturbed.

The causes of diabetes insipidus vary by type.

1. Central simple insipidus – is caused by a significant deficiency of vasopressin, hypothalamus or pituitary gland due to their damage, due to:

1. postoperative injuries;
2. road accident injuries;
3. hypothalamus tumor;
4. vascular diseases;
5. neuroinfection;
6. autoimmune reaction.

Important! Injury to the pituitary gland or hypothalamus can also be congenital. It inherits as an autosomal dominant or autosomal recessive form.

2. Diabetic renal insipidus – in turn, it is caused by the lack of sensitivity of the renal collecting tubules to vasopressin. Other reasons are:

1. abnormal vasopressin binding sites of genetic origin (symptom appearing mainly in men);
2. kidney damage, e.g. from amyloidosis, kidney cysts, or interstitial nephritis;
3. hypokalaemia (low blood potassium);
4. taking certain medications;
5. hypercalcemia (increase in blood calcium levels);
6. chronic treatment with lithium carbonate.

3. Gestational diabetes mellitus – only occurs in pregnant women. Vasopressin is destroyed by the enzyme produced by the mother’s placenta. After childbirth, the ailment disappears.

Symptoms of diabetes insipidus

The basic symptom of diabetes insipidus is a very high thirst of the patient, caused by the need to urinate frequently (even at night). It is important to replenish your fluids to avoid high levels of sodium in your blood. Diarrhea is not a direct threat to life if the patient remembers to replenish fluids. The situation is different in the following people: unconscious, with difficulty swallowing, sick and young children who are unable to replenish fluids.

Symptoms of diabetes insipidus are directly related to the characteristics of the disease. Occurs:

1. frequent dilution of urine,
2. bedwetting at night (especially in children)
3. increased thirst,
4. constipation
5. infants may develop vomiting, constipation and a high temperature,
6. visual disturbances (related to an intracranial tumor),
7. headaches,
8. disturbances in the secretion of other hormones,
9. increased sodium levels
10. neurological symptoms, disturbance of consciousness.

Diagnosis of diabetes insipidus

The diagnosis of diabetes insipidus is based on a medical history and physical examination. It is recommended to perform blood electrolytes, general urinalysis, plasma and urine osmolality, urine specific gravity and XNUMX-hour urine volume. In addition to these tests, a dehydration test and a vasopressin test are also performed to distinguish central diabetes insipidus from renal diabetes insipidus.

Typical features of diabetes insipidus:

1. low urine osmolality,
2. low specific gravity of urine,
3. polyuria
4. large amounts of sodium in the blood serum.

If the doctor diagnoses simple central diabetes insipidus – MRI of the hypothalamic-pituitary area is recommended.

Simple diabetes insipidus – treatment

Central simple insipidus

Treatment of this type of diabetes insipidus is a substitution treatment that consists in supplementing the deficiency of vasopressin – desmopressin, which has a similar effect to it. Taking the agents is determined by the doctor individually, it can be administered orally or intranasally. If the patient is unconscious and unable to take the preparations on his own, they are administered subcutaneously, intravenously or intramuscularly. You should limit your fluid intake while taking the drug, as overhydration may occur. Diluted mixtures and more fluids are used in breastfed infants. Occasionally, central diabetes insipidus requires neurosurgical treatment.

Renal diabetes insipidus

Treatment of diabetes insipidus consists of treating the underlying disease and adequate hydration of the patient. In this case, it is important to choose an appropriate diet with a low salt content and to use a thiazide diuretic. It is a diuretic and reduces the amount of urine produced pardoxically. In addition, indomethacin is used.

Patients with proper care and taking the hormone regularly can live a normal life. Important! Ignoring diabetes insipidus and taking no treatment leads to confusion and dehydration coma.