Diabetes insipidus (DI) is a rare disorder that differs greatly from the familiar type 2 and type 1 diabetes. DI happens when your body lacks enough hormones to signal to your kidneys to hang on to the right amount of water.
As a result, your body loses too much water through your urine. That makes you severely thirsty. The name of the condition comes from the word “insipid,” to describe the watery pee. DI is also called water diabetes.
Diabetes insipidus usually doesn’t cause serious problems. Adults rarely die from it as long as they drink enough water. But the risk of death is higher for infants, seniors, and those who have mental illnesses. That may be because they have trouble recognizing their thirst, or they can’t do anything about it.
The average person gets rid of 1-2 quarts of urine per day. People with DI can pee 3-20 quarts a day. This condition is called polyuria. The huge output of urine can make you dangerously dehydrated. It also can knock out the balance of electrolytes sodium and potassium that you need for your nerves to work well.
There are four types of diabetes insipidus. Each can have different causes, treatments, and long-term outlook. In most cases, you can manage the condition well with your doctor’s care.
Central Diabetes Insipidus
This is when your body doesn’t make enough of a hormone called vasopressin. You need it to keep the amount of fluids in your body in balance.
That can happen after an infection, surgery, tumor, or for other reasons.
Some babies can be born with central DI because of genetic disorders.
A low-sodium (salt) diet may be enough to treat some mild or moderate cases of central diabetes insipidus. A main first goal of treatment is to help you get more sleep that’s interrupted by repeated trips to the bathroom.
For others, a man-made hormone called desmopressin works well to replace or boost your missing vasopressin. Desmopressin pills are the preferred form of treatment, although the hormone can be taken as a shot or nasal spray too. While using desmopressin, you must take the correct dose and regulate your fluid intake. Too many fluids can cause headaches, dizziness, bloating, and dangerously low sodium levels. The treatment can control your symptoms like dehydration, weight loss, high fevers, or crankiness. But it isn’t a cure.
Nephrogenic Diabetes Insipidus
You can be born with this condition or get it later in life. Newborns may not get enough nutrition to grow and thrive. Their bladder or kidneys can get infected often. Over time, that can cause the kidneys to fail. But with the right treatment, babies with nephrogenic DI can live a normal life span with few complications.
If your nephrogenic DI wasn’t hereditary, it may have been caused by:
- Kidney disease
- Certain medications, including lithium, the antiviral drug foscarnet, and the antipsychotic drug clozapine
- Too much calcium in the blood (hypercalcemia)
- Too low blood levels of potassium (hypokalemia)
- Blockages in the urinary tract
Addressing the root causes of your nephrogenic DI can give you a good prognosis and sometimes even make the condition go away. Diuretics, aspirin, or ibuprofen may help limit how much you pee or help your kidneys flush out fluids from your body.
Dipsogenic Diabetes Insipidus
Researchers have not found a good treatment for this condition. It can result from an injury or a flaw in the brain’s hypothalamus, which controls thirst. Certain drugs or mental illnesses also can cause it. Dipsogenic DI can make you drink uncontrollably to quench your thirst.
Treating any mental disorder that’s causing it may help. For others, ice chips, sprays, and mouthwashes may ease the dry mouth and the thirst. One possible danger is water intoxication, which can be deadly.
Gestational Diabetes Insipidus
This can happen to many women during the last 3 months of pregnancy. Common symptoms include extreme thirst and urination. Gestational DI can be caused by hormonal changes or because an enzyme in the womb breaks down vasopressin, which helps regulate your body fluids.
Carrying two or more babies raises your chances for getting it. But any problems tend to be mild, and they usually go away within weeks after delivery.
Managing Diabetes Insipidus
For all forms of diabetes insipidus, the biggest concerns are dehydration and electrolyte imbalances. Keep a watch for symptoms of those problems, including:
- Big thirst
- Dry mouth, lips, and skin
- Tiredness or lightheadedness
- Urinating often at night
- Cramps or nausea
- Dark or little urine
- Shallow or fast breathing
- Low blood pressure
- Rapid or irregular heartbeat
With treatment and your doctor’s guidance, you likely can live safely with most forms of diabetes insipidus.