Diabetes insipidus

Diagnosis

The following tests are used to identify diabetic insipidus:

• Water deprivation test. You’ll be instructed to refrain from drinking fluids for a number of hours while being observed by a doctor and medical staff. Your doctor will monitor changes in your body weight, urine production, and the concentration of your urine and blood as fluids are withheld from you. Your doctor will also check your blood levels of ADH. During this test, your doctor might provide artificial ADH. This will reveal whether your body is making enough ADH and whether your kidneys are able to react to ADH as expected.
• Urine test. Testing urine to determine if it contains a high amount of water can be beneficial in diagnosing diabetes insipidus.
• Blood test. Examining the levels of specific substances in the blood, such as sodium, potassium, and calcium, can assist in diagnosing diabetes insipidus and may aid in determining the type of the condition.
• Magnetic Resonance Imaging (MRI). An MRI can be used to check for anomalies in the pituitary gland or hypothalamus. This examination is non-invasive. It creates precise images of the brain’s tissues using radio waves and a strong magnetic field.
• Genetic screening. Your doctor could advise genetic testing if other members of your family have experienced issues with excessive urinating.

Treatment

The types of diabetes insipidus that you have will determine your treatment options.

You might simply need to drink more water if you have mild diabetic insipidus.

• Central diabetes insipidus. Your doctor will first address the abnormality if the condition is brought on by one, such as a tumor, in the pituitary gland or hypothalamus. Desmopressin (DDAVP, Nocdurna), a synthetic hormone, is typically used to treat this type. Anti-diuretic hormone (ADH) is replaced by this medicine, which also lessens urination. Desmopressin comes in tablet, nasal spray, and injection forms. The majority of people with central diabetes insipidus still produce some ADH, even though the amount can change daily. Therefore, the dosage of desmopressin you require may also change. Desmopressin overdose can result in water retention and potentially dangerously low blood salt levels.
• Nephrogenic diabetes insipidus. Desmopressin won’t help because the kidneys don’t react to ADH effectively in this type of diabetes insipidus. Instead, to lessen the volume of urine your kidneys produce, your doctor could advise a low-salt diet. Additionally, you must consume enough water to stay hydrated.

Your symptoms might get better with treatment with the medication hydrochlorothiazide. Although the diuretic drug hydrochlorothiazide typically causes an increase in urine production, it can also cause a decrease in urine production in some individuals with nephrogenic diabetes insipidus.

Stopping the meds you’re taking could help if your symptoms are brought on by them. Nevertheless, consult your doctor before stopping any medication.

• Gestational diabetes insipidus. The synthetic hormone desmopressin is the most common form of treatment for those who have pregnancy diabetes insipidus.
• Primary polydipsia. Other than reducing fluid intake, there is no specific treatment for this type of diabetes insipidus. If a mental disease is connected to the condition, treating the mental illness may help with the symptoms of diabetes insipidus.