A patient with diabetes insipidus presents to the emergency room for treatment of dehydration

Overview

Diabetes insipidus (die-uh-BEE-teze in-SIP-uh-dus) is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance leads you to produce large amounts of urine. It also makes you very thirsty even if you have something to drink.

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When to see a doctor
From Mayo Clinic to your inbox
Risk factors
Complications
Dehydration
Electrolyte imbalance
What IV fluids are given for diabetes insipidus?
Which is used to treat diabetes insipidus?
Does diabetes insipidus cause dehydration?
What electrolyte should be monitored with diabetes insipidus?

While the terms "diabetes insipidus" and "diabetes mellitus" sound similar, they're not related. Diabetes mellitus — which involves high blood sugar levels and can occur as type 1 or type 2 — is common and often referred to simply as diabetes.

There's no cure for diabetes insipidus. But treatments can relieve your thirst and decrease your urine output and prevent dehydration.

Symptoms

Signs and symptoms of diabetes insipidus include:

Being extremely thirsty
Producing large amounts of pale urine
Frequently needing to get up to urinate during the night
Preferring cold drinks

If your condition is serious and you drink a lot of fluids, you can produce as much as 20 quarts (about 19 liters) of urine a day. A healthy adult typically urinates an average of 1 to 2 quarts (about 1 to 2 liters) a day.

An infant or young child with diabetes insipidus may have the following signs and symptoms:

Heavy, wet diapers
Bed-wetting
Trouble sleeping
Fever
Vomiting
Constipation
Delayed growth
Weight loss

When to see a doctor

See your doctor immediately if you notice excessive urination and extreme thirst.

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Causes

Diabetes insipidus occurs when your body can't properly balance the body's fluid levels.

Your kidneys filter the fluid portion of your blood to remove waste products. The majority of the fluid is returned to the bloodstream while the waste and a smaller amount of fluid make up urine. Urine is excreted from your body after being temporarily stored in your bladder.

A hormone called anti-diuretic hormone (ADH), or vasopressin, is needed for the fluid that's filtered by the kidneys to go back into the bloodstream. ADH is made in a part of the brain called the hypothalamus and stored in the pituitary gland, a small gland found in the base of the brain. Conditions that cause a deficiency of ADH or block the effect of ADH result in production of excess urine.

If you have diabetes insipidus, your body can't properly balance fluid levels. The cause depends on the type of diabetes insipidus you have. Types include:

Central diabetes insipidus. Damage to the pituitary gland or hypothalamus from surgery, a tumor, head injury or illness can cause central diabetes insipidus by affecting the usual production, storage and release of ADH. An inherited genetic disease also can cause this condition.
Nephrogenic diabetes insipidus. Nephrogenic diabetes insipidus occurs when there's a defect in the structures in your kidneys that makes your kidneys unable to properly respond to ADH.
The defect may be due to an inherited (genetic) disorder or a chronic kidney disorder. Certain drugs, such as lithium or antiviral medications such as foscarnet (Foscavir), also can cause nephrogenic diabetes insipidus.
Gestational diabetes insipidus. Gestational diabetes insipidus is rare. It occurs only during pregnancy when an enzyme made by the placenta destroys ADH in the mother.
Primary polydipsia. Also known as dipsogenic diabetes insipidus, this condition can cause production of large amounts of diluted urine from drinking excessive amounts of fluids.
Primary polydipsia can be caused by damage to the thirst-regulating mechanism in the hypothalamus. The condition has also been linked to mental illness, such as schizophrenia.

Sometimes, there's no obvious cause of diabetes insipidus. However, in some people, the disorder may be the result of an autoimmune reaction that causes the immune system to damage the cells that make vasopressin.

Risk factors

Nephrogenic diabetes insipidus that's present at or shortly after birth usually has an inherited (genetic) cause that permanently changes the kidneys' ability to concentrate urine. Nephrogenic diabetes insipidus usually affects males, though women can pass the gene on to their children.

Complications

Dehydration

Diabetes insipidus may lead to dehydration. Dehydration can cause:

Dry mouth
Changes in skin elasticity
Thirst
Fatigue

Electrolyte imbalance

Diabetes insipidus can cause an imbalance in minerals in your blood, such as sodium and potassium (electrolytes), that maintain the fluid balance in your body. Symptoms of an electrolyte imbalance may include:

Weakness
Nausea
Vomiting
Loss of appetite
Muscle cramps
Confusion

What IV fluids are given for diabetes insipidus?

Fluid replacement Most patients with diabetes insipidus (DI) can drink enough fluid to replace their urine losses. When oral intake is inadequate and hypernatremia is present, replace losses with dextrose and water or an intravenous (IV) fluid that is hypo-osmolar with respect to the patient's serum.

Which is used to treat diabetes insipidus?

Central diabetes insipidus. Typically, this form is treated with a synthetic hormone called desmopressin (DDAVP, Nocdurna). This medication replaces the missing anti-diuretic hormone (ADH) and decreases urination. You can take desmopressin in a tablet, as a nasal spray or by injection.

Does diabetes insipidus cause dehydration?

Dehydration. If you have diabetes insipidus, your body will find it difficult to retain enough water, even if you drink fluid constantly. This can lead to dehydration, a severe lack of water in the body.

What electrolyte should be monitored with diabetes insipidus?

Central Diabetes Insipidus It is important to monitor hyponatremia, as water retention can lead to sodium concentration changes that may cause brain injury.