What is diabetes insipidus?

This is a condition that causes the body to make too much urine. This can happen when there are problems with a hormone called “antidiuretic hormone,” which helps balance the amount of fluid in the body.

Diabetes insipidus is not the same as diabetes mellitus. Diabetes mellitus is a much more common disease, and what people usually mean when they say “diabetes.” Some of the symptoms, like urinating a lot, are the same. But otherwise, they are very different conditions with different treatment.

Because the name “diabetes insipidus” can be confusing, experts also use different names. There are 2 kinds of diabetes insipidus:

• Arginine vasopressin deficiency – This is sometimes also called “central diabetes insipidus.” In people with this type, the body doesn’t make enough antidiuretic hormone to keep the amount of fluid in balance.
• Arginine vasopressin resistance – This is sometimes also called “nephrogenic diabetes insipidus.” In people with this type, the body makes enough antidiuretic hormone, but the kidneys don’t respond to it.

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?

Yes. If your doctor thinks that you might have this condition, they will order tests. This can tell them if you have diabetes insipidus, and if so, which type.

Tests 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

Your doctor might give you a medicine 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 of the treatments for diabetes insipidus work by reducing the amount of urine the body makes.

• If you have arginine vasopressin deficiency (central diabetes insipidus), your doctor will probably prescribe a medicine called desmopressin (brand names: DDAVP, Stimate). It comes as a nasal spray, a pill, or a shot under the skin. It replaces the antidiuretic hormone missing from your body. Doctors sometimes prescribe other medicines as well.
• If you have arginine vasopressin resistance (nephrogenic diabetes insipidus), the treatment options are different. With this type, the kidneys usually don’t respond to antidiuretic hormone because they are damaged. Often, the kidney damage is caused by other health problems or the medicines used to treat them. If possible, treating the other health problem or stopping the medicines can help. Certain medicines, including some used to treat high blood pressure, might also help.

Your doctors might also recommend a low-salt, low-protein diet. This might help control symptoms.

Is there anything I can do on my own to feel better?

Yes. Some people feel better if they eat a diet 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. They 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 people with diabetes insipidus can have normal pregnancies. But diabetes insipidus can get worse during pregnancy. Desmopressin is safe to take during pregnancy.

When should I call the doctor?

If you are being treated for diabetes insipidus, see your doctor or nurse right away if you:

• Are vomiting
• Have nausea
• Have a headache
• Feel very tired

These symptoms could mean that your medicine dose needs to be changed.