Diabetes insipidus, which is not common, occurs when there is disruption in normal functioning of the pituitary gland. There is deficiency of a hormone (vasopressin) which adversely affects body’s fluid control. The disorder can appear as frequent urination, excessive thirst and passing considerable amounts of urine in a day (as much as 20 liters).
This condition is almost permanent; but in rare cases, temporary diabetes insipidus can also happen. Know some important facts about the condition which can help when living with one.
Diabetes Insipidus vs. Diabetes Mellitus
Diabetes insipidus is different from diabetes mellitus (sugar diabetes), although symptoms may be confusing. In diabetes insipidus, the body loses the stimulus for fluid retention which consequently gets lost from the body. There is excessive urination and/or feeling of thirst on a usual basis.
Diabetes mellitus is a more common condition and occurs owing to a disorder of the pancreas. Here, the body is unable to control blood sugar level. Although here also, a person can have similar symptoms as passing excess urine and usually feeling thirsty, diabetes mellitus is quite different from diabetes insipidus. The treatment of diabetes insipidus focuses on taking vasopressin whereas diabetes mellitus is treated with regular injections of insulin or medications used to control sugar levels. Both conditions arise out of different causes and entail different treatment procedures.
Treatment of Diabetes Insipidus
Treatment of diabetes insipidus is based upon the underlying disorder. Diabetes insipidus does not lead to chronic problems when treated. In its mild form (cranial diabetes insipidus), no treatment may be needed until the patient can compensate for the loss of fluid owing to excessive urination. This can be done by drinking more water. However, desmopressin can be used for treatment in case found necessary.
Other forms of diabetes insipidus, like nephrogenic diabetes insipidus, can be treated with medications (known as thiazide diuretics). Thiazide diuretics decrease urine production by the kidneys; however, treatment should focus on removing the cause of the underlying condition wherever possible. Nephrogenic diabetes insipidus caused by medication (like lithium) may be managed by stopping the medication. It should be complemented with sufficient fluid intake.
However, several years of lithium use can make the nephrogenic diabetes insipidus permanent. Other medications include anti-inflammatory medication and diuretics. Another form, central diabetes insipidus, can be treated with vasopressin taken in the form of a nasal spray or tablets. When using vasopressin for treatment, care should be taken to avoid excessive usage. Too much usage of vasopressin can lead to too much fluid retention in the body and consequent into weight gain, swelling of the limbs, headache and increase in blood pressure.
Increased fluid retention can reduce concentration of salts in the blood and even lead to fits. It is better to limit vasopressin usage or restrict to a minimal intake. If you miss a dose when taking nasal solution or oral tablets, you may take the missed dose. However, try to delay the next dose. Drink generously to compensate for the loss caused to a missed dose. Consult your doctor in such a case for appropriate advice.
Precautions and Helpful Tips
It is important to prevent dehydration with diabetes insipidus. Consult your doctor for the exact amount of fluid you need to take to avoid dehydration. Remember to have water with you wherever you are, particularly during hot weather. Keep the medication (vasopressin) in a cool place but not frozen. Nasal spray and drops can become less effective when left outside for long. Consult your doctor for best advice on storage.
Infants and young children should be given water every two hours. It is helpful when you can wear a medical alert identity. In case of a medical emergency, prompt medical intervention can be delivered when others around are aware of your special need. Children need special care and consideration.
School authority, particularly the teacher, should be made aware of the condition of a diabetic child who needs unhindered access to fluids and toilet. Since children cannot hold urine for long, they should be allowed to urinate even during important events like examinations. This can avoid embarrassment and inconvenience. Alcohol can lower vasopressin secretion. Large amount of alcohol intake can interfere with vasopressin and cause risk of water overload.
It is important to prevent yourself from having a cold affect. This may interfere with the treatment when you are using a nasal spray or solution. If your other nostril can work fine, treatment may remain unhindered. But if your entire nose is blocked, the medicine may have subdued effect due to lack of adequate absorption. People having deficient in other pituitary hormones (multiple pituitary hormone deficient
(MPHD) can affect their diabetes insipidus. A thyroid or pituitary hormone deficiency can affect diabetes insipidus.
Diabetes Insipidus in children
When diabetes insipidus is found in small babies, parents can find it difficult to recognize the symptoms. Large amounts of urine and excessive thirst can cause poor weight gain. Small babies may apparently seem hungry and in response, get more milk than water. Herein, they can actually gain weight contrary to the usual.
Treatment can be administered as oral medications and nasal drops. Caution is required because small babies should be given lesser dosage of a medicine. Nasal drops may be diluted to arrive at an accurate composition. When a plastic tube (which comes along with vasopressin) cannot be used, a 1ml syringe can serve the purpose. Young children with diabetes insipidus may have diarrhea or vomiting. They need special care and, perhaps, hospitalization can be the best option to ensure prompt and appropriate medical assistance.
Living with Diabetes Insipidus
Being diagnosed with diabetes insipidus can demand changes to lifestyle. Your special needs may restrict you from doing many things like others. For example, while doing exercises, you need to ensure sufficient fluid intake to avoid dehydration.
However, diabetes insipidus does not lead to kidney failure or dialysis with the kidneys doing their primary job of blood filtration. Diabetes insipidus rarely occurs during pregnancy. When diabetes insipidus is treated, it is unlikely to cause any severe problems. You should, however, be cautious of frequent urination and thirst. If you have a problem, consult your doctor immediately for intervention and prompt resolution.