Diabetes Insipidus: Diagnosis and Treatment

Since the signs and symptoms of diabetes insipidus can be triggered by other conditions, your doctor will carry out a number of tests. If your doctor determines you have diabetes insipidus, he or she will have to determine which type of diabetes insipidus you have, because the treatment is different for each kind of the disease.

Diagnosis

Some of the tests doctors frequently use to diagnose and identify the type of diabetes insipidus and sometimes, its cause, consist of:

  • Water deprivation test. This test verifies the medical diagnosis and assists identify the cause of diabetes insipidus. Under medical supervision, you’ll be asked to stop consuming fluids for a time so that your doctor can determine changes in your body weight, urine output and the concentration of your urine and blood when fluids are withheld. Your doctor might also measure blood levels of ADH or administer synthetic ADH during this test. The water deprivation test is carried out under close supervision in children and pregnant women to make sure no greater than 5 percent of body weight is lost during the test.
  • Urinalysis. Urinalysis is the physical and chemical assessment of urine. If your urine is less concentrated — suggesting the amount of water is high relative to other excreted substances — it might be due to diabetes insipidus.
  • Magnetic resonance imaging (MRI). An MRI of the head is a noninvasive procedure that uses an effective magnetic field and radio waves to build comprehensive photos of brain tissues. Your doctor may wish to perform an MRI to look for abnormalities in or near the pituitary gland.

Genetic screening

If your doctor suspects an acquired type of diabetes insipidus, he or she will look at your family history of polyuria and may recommend genetic screening.

Treatment

Treatment of diabetes insipidus depends upon what kind of the condition you have. Treatment options for the most common types of diabetes insipidus consist of:

  • Central diabetes insipidus. Due to the fact that the cause of this type of diabetes insipidus is an absence of anti-diuretic hormonal agent (ADH), treatment is typically with an artificial hormonal agent called desmopressin. You can take desmopressin as a nasal spray, as oral tablets or by injection. The synthetic hormone will get rid of the boost in urination. For most people with this kind of the condition, desmopressin is safe and reliable. If the condition is caused by a problem in the pituitary gland or hypothalamus (such as a growth), your doctor will first treat the irregularity. Desmopressin ought to be thought about a medication you take as required. This is due to the fact that in most people, the shortage of ADH is not complete, and the quantity made by the body can differ day to day. Taking more desmopressin than needed can result in too much water retention and low sodium levels in the blood. Symptoms of low salt include lethargy, headache, nausea and, in severe cases, seizures. In moderate cases of central diabetes insipidus, you may need just to increase your water consumption.
  • Nephrogenic diabetes insipidus. This condition is the result of your kidneys not correctly reacting to ADH, so desmopressin is not a treatment choice. Instead, your doctor might prescribe a low-salt diet to assist minimize the quantity of urine your kidneys make. You’ll also have to drink adequate water to prevent dehydration. The drug hydrochlorothiazide, used alone or with other medications, might enhance symptoms. Although hydrochlorothiazide is a diuretic (generally used to increase urine output), in many cases it can reduce urine output for people with nephrogenic diabetes insipidus. If symptoms from nephrogenic diabetes insipidus are due to medications you’re taking, stopping these medications may help; nevertheless, don’t stop taking any medication without first speaking with your doctor.
  • Gestational diabetes insipidus. Treatment for most cases of gestational diabetes insipidus is with the artificial hormone desmopressin. In rare cases, this form of the condition is triggered by a problem in the thirst mechanism. In these uncommon cases, physicians don’t recommend desmopressin.
  • Primary polydipsia. There is no specific treatment for this kind of diabetes insipidus, aside from decreasing the quantity of fluid consumption. Nevertheless, if the condition is triggered by mental disorder, dealing with the mental illness might ease the symptoms.

The majority of patients with diabetes insipidus (DI) can drink sufficient fluid to replace their urine losses. When oral consumption is insufficient and hypernatremia is present, change losses with dextrose and water or an intravenous (IV) fluid that is hypo-osmolar with regard to the patient’s serum. Do not administer sterile water without dextrose intravenously, as it can cause hemolysis.

To prevent hyperglycemia, volume overload, and overly rapid correction of hypernatremia, fluid replacement must be provided at a rate no higher than 500-750 mL/h. An excellent guideline is to decrease serum sodium by 0.5 mmol/L (0.5 mEq/L) every hour. The water deficit might be determined on the basis of the presumption that body water is around 60% of body weight.

Lifestyle and natural home remedy

If you have diabetes insipidus:

  • Prevent dehydration. As long as you take your medication and have access to water when the medication’s impacts wear off, you’ll avoid major issues. Strategy ahead by bring water with you any place you go, and keep a supply of medication in your travel bag, at work or at school.
  • Use a medical alert bracelet or carry a medical alert card in your wallet. If you have a medical emergency, a health care expert will acknowledge immediately your need for unique treatment.

Also read: Diabetes Insipidus: Symptoms and Causes

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