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Central Diabetes Insipidus

Central Diabetes Insipidus

What is diabetes insipidus? — Diabetes insipidus is a condition that causes the body to make too much urine. This can happen when there are problems with a hormone called "anti-diuretic hormone," which helps balance the amount of fluid in the body.
There are 2 kinds of diabetes insipidus:
Central diabetes insipidus – In people with central diabetes insipidus, the body doesn't make enough anti-diuretic hormone to keep the amount of fluid in balance.
Nephrogenic diabetes insipidus – In people with nephrogenic diabetes insipidus, the body makes enough anti-diuretic hormone, but the kidneys don't respond to it.
Diabetes insipidus is not the same as diabetes mellitus. Diabetes mellitus is a much more common disease that most people know simply as "diabetes." Some of the symptoms, like urinating a lot, are the same. But otherwise, they are very different conditions.
What are the symptoms of diabetes insipidus? — The symptoms are:
Needing to urinate often, sometimes in the middle of the night
Making large amounts of urine
Feeling very thirsty
Is there a test for diabetes insipidus? — Your doctor should be able to tell that you have the condition based on your symptoms. But in some cases, doctors will need to do tests. These might include:
A test to measure how much urine your body makes. For this test, you stop drinking fluids for 2 to 3 hours. Then the doctor records how much urine you make over the next 2 hours and possibly longer.
Tests to measure certain substances in your urine.
Plus, the doctor might give you a drug that's often used to treat the condition. Your body's response will help reveal which type of diabetes insipidus you have.
How is diabetes insipidus treated? — The right treatment for you will depend on what kind of diabetes insipidus you have. In general, all the treatments for diabetes insipidus work by reducing the amount of urine the body makes.
If you have central diabetes insipidus, following a diet that's low in salt and protein might help control your symptoms. If diet changes don't help enough, your doctor might prescribe a medicine called desmopressin (brand names: DDAVP, Stimate). You can take this medicine as a nasal spray, a pill, or as a shot under the skin. This medicine replaces the anti-diuretic hormone missing from your body. Doctors sometimes prescribe other drugs as well.
People who have nephrogenic diabetes insipidus have different treatment options. In this form of diabetes insipidus, the kidneys usually aren't responding to anti-diuretic hormone because they are damaged. Often, the kidney damage is caused by other health problems or the medicines people take to treat them. If possible, treating the other health problem or stopping the medicines can help. Doctors also might recommend a low-salt, low-protein diet. Plus, certain medicines, including some used to treat high blood pressure, might help.
Are there warning signs I should watch for? — If you are being treated for diabetes insipidus, see your doctor or nurse right away if have any of these symptoms:
Feeling very tired
Having these symptoms could mean you need a different dose of the medicine you take to treat your diabetes insipidus.
Is there anything I can do on my own to feel better? — Yes. Some people feel better if they eat a diet that is low in sodium (the main ingredient in salt) and protein. These diet changes will help you make less urine.
If you're not sure what to eat, talk to your doctor or nurse. He or she might refer you to a dietitian (food expert) who can help you choose what to eat.
Another helpful tip is called "double voiding." This involves urinating more than once to empty your bladder. After you urinate, wait 10 to 15 minutes, and then urinate again to empty your bladder completely.
What if I want to get pregnant? — Most women with diabetes insipidus can have normal pregnancies. But be aware that diabetes insipidus can get worse during pregnancy. Desmopressin is safe for both mother and baby.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 17196 Version 4.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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