What Are the Main Types of Diabetes Insipidus?
Diabetes insipidus, also known as DI, can be defined as a disease in which the secretion of or response to the pituitary hormone vasopressin is impaired, resulting in the loss of too many quantities of dilute urine often with dehydration and insatiable thirst. It is a disorder of salt and water metabolism noticeable by intense thirst and heavy urination. Diabetes insipidus takes place when the body cannot regulate how it handles fluids. This is not related to diabetes; the condition of diabetes insipidus is caused by a hormonal abnormality. Diabetes insipidus causes excessive thirst, water-electrolyte imbalance, dehydration, fatigue, or malaise.
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Diabetes Insipidus Causes
Damage to the pituitary gland or hypothalamus from surgery, a tumour, a head injury, an illness or an inherited genetic disease can cause central diabetes insipidus by affecting the usual production, storage and release of ADH. Diabetes insipidus causes a significant risk of dangerous dehydration as well as a range of other illnesses and conditions. A chemical called vasopressin(AVP), which is also known as antidiuretic hormone(ADH) for which diabetes insipidus causes. Arginine vasopressin is produced by the hypothalamus and is stored in the pituitary gland until needed. Diabetes is the most common cause of kidney failure in the US.
Diabetes Insipidus Symptoms
It is one of the rare disorders that develop when kidneys of a person go by an abnormally more amount of urine which is insipid(odourless and dilute). In the case of whole-body, the person may experience excessive thirst, water-electrolyte imbalance, dehydration, fatigue, or malaise. In the case of urinary, the person may have excessive urination, frequent urination, or even bedwetting. Apart from all these, headaches or weight loss is also frequent as diabetes insipidus symptoms.
Types of Diabetes Insipidus
There are four types of diabetes insipidus, but the two main types of diabetes insipidus are as follows:
Cranial Diabetes Insipidus: in this case, the body does not produce enough antidiuretic hormone(AVP), so excessive amounts of water are lost in large quantities of urine. This happens when damage to the hypothalamus of a person or pituitary gland causes disruptions in the normal production, storage and release of vasopressin. Damage of hypothalamus or pituitary gland can result from surgery, infection, inflammation, a tumour, or a head injury.
Nephrogenic Diabetes Insipidus – this condition is caused by different factors, which includes the damage to the kidneys, presence of excessive levels of calcium, chronic kidney disease, urinary tract blockage or low potassium levels in the body. In this case, AVP produces more, but, for a variety of reasons, the kidneys do not respond to the antidiuretic hormone in the usual way.
The Other Two Types of Diabetes Insipidus Are:
Dipsogenic Diabetes Insipidus – the defect of the thirst mechanism in the hypothalamus causes this condition. These defects result in an abnormal increase in the intake of thirst and fluid that suppresses vasopressin secretion and increases excretion of urine. Certain medications or mental health problems may predispose a person to adipogenic diabetes insipidus.
Gestational Diabetes Insipidus – this condition is caused during pregnancy, especially when the mother's ADH gets destroyed by the enzymes of the placenta. In a few cases, an enzyme made by the placenta – a temporary organ joining mother and baby breaks down the vasopressin of the mother. Most pregnant women who develop gestational diabetes insipidus have a mild case but do not have noticeable symptoms.
Solved Example
Question 1: What Is The Role of Emotional Intelligence In Diabetes?
Answer: The purpose of the study is to investigate the effect of an emotional intelligence(EI) program on the health-related quality of life and well-being of individuals with type 2 diabetes. So the results had no differences between the quality of life, prosperity, and emotional intelligence levels of the study and control groups before the commencement of the program.
Did You Know?
Diabetes insipidus facts: it is a rare disorder caused by problems related to the antidiuretic hormone(ADH) or its receptor and causes frequent urination. Diabetes insipidus is not associated with diabetes mellitus. The diagnosis for diabetes insipidus is based on a series of tests like urinalysis and fluid deprivation test. Treatment for diabetes insipidus depends on the category of diabetes insipidus. Diabetes can lead to chronic kidney insipidus.
FAQs on Diabetes Insipidus Explained: Causes, Symptoms & Key Facts
1. What is the main difference between Diabetes Insipidus and Diabetes Mellitus?
The primary difference lies in the hormone and substance involved. Diabetes Insipidus is a disorder of water balance caused by a problem with the hormone vasopressin (ADH), leading to excessive thirst and urination of diluted, tasteless urine. In contrast, Diabetes Mellitus is a metabolic disorder related to blood sugar, caused by a lack of or resistance to the hormone insulin, resulting in high blood sugar and sugary urine.
2. What are the key symptoms of Diabetes Insipidus?
The two most prominent symptoms of Diabetes Insipidus are:
- Extreme thirst (polydipsia): An intense, unquenchable need to drink fluids, often water.
- Excessive urination (polyuria): Producing an unusually large volume of pale, diluted urine, which can lead to frequent trips to the bathroom, even at night.
These symptoms can lead to dehydration if fluid intake is not sufficient.
3. What causes Diabetes Insipidus to occur?
The cause depends on the type. The most common cause is a problem with the antidiuretic hormone (ADH), also called vasopressin. Central Diabetes Insipidus occurs when the pituitary gland doesn't produce enough ADH, often due to injury, surgery, or an inherited genetic issue. Nephrogenic Diabetes Insipidus happens when the kidneys fail to respond to ADH properly.
4. Are there different types of Diabetes Insipidus?
Yes, there are four main types of Diabetes Insipidus:
- Central DI: Caused by damage to the pituitary gland or hypothalamus, resulting in a lack of ADH production.
- Nephrogenic DI: Occurs when the kidneys are unable to respond to ADH.
- Dipsogenic DI: Caused by a defect in the thirst mechanism in the brain, leading to abnormal thirst and excessive fluid intake.
- Gestational DI: A rare, temporary condition that can occur during pregnancy when an enzyme made by the placenta destroys the mother's ADH.
5. How does a problem with vasopressin (ADH) lead to so much urination?
Vasopressin, also known as the Antidiuretic Hormone (ADH), acts as a chemical messenger that tells your kidneys to reabsorb water into the body. When ADH levels are low, or when the kidneys don't respond to it, this signal is lost. As a result, the kidneys fail to conserve water, and large amounts of fluid that would normally be reabsorbed are instead flushed out of the body as diluted urine.
6. Why is it called 'diabetes' if it has nothing to do with blood sugar?
The word 'diabetes' originates from a Greek term that means 'to pass through,' which refers to the symptom of excessive urination common to both conditions. The second part of the name distinguishes them. 'Insipidus' is Latin for 'tasteless,' referring to the diluted, watery urine. 'Mellitus' is Latin for 'honey-sweet,' referring to the sugary urine found in people with high blood sugar.
7. How do doctors typically test for Diabetes Insipidus?
Doctors use several tests to diagnose Diabetes Insipidus. A common one is the water deprivation test, where a person stops drinking fluids for several hours to see how their body responds. During the test, doctors measure changes in body weight, urine output, and the concentration of urine and blood. This helps them determine if the body is producing and using ADH correctly. An MRI of the brain may also be used to check the pituitary gland.
8. Can Diabetes Insipidus be cured or go away?
Whether Diabetes Insipidus can be resolved depends entirely on its cause. If it is caused by a temporary factor, such as a medication or pregnancy (gestational DI), it may go away once the underlying cause is removed. However, for chronic types like central or nephrogenic DI caused by permanent damage or genetic factors, it is not curable but can be effectively managed with lifelong treatment, such as hormone therapy and ensuring adequate water intake.
