{"id":1004,"date":"2022-06-06T15:00:00","date_gmt":"2022-06-06T15:00:00","guid":{"rendered":"https:\/\/survivingdiabetes.com\/?p=1004"},"modified":"2022-05-01T20:03:38","modified_gmt":"2022-05-01T20:03:38","slug":"diagnosing-and-treating-diabetes-insipidus","status":"publish","type":"post","link":"https:\/\/survivingdiabetes.com\/diagnosing-and-treating-diabetes-insipidus\/","title":{"rendered":"Diagnosing and Treating Diabetes Insipidus"},"content":{"rendered":"<h1><\/h1>\n<p>A health care professional can diagnose diabetes insipidus by performing a water deprivation test. In this test, a health care professional will measure the amount of urine you produce while measuring your weight and blood sugar levels. He or she may also administer medicines such as man-made vasopressin or other substances. Another test is MRI, or magnetic resonance imaging. MRIs can look for damage to the hypothalamus and pituitary gland.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_63 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<p class=\"ez-toc-title\">Table of Contents<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-66051fe243953\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-66051fe243953\"  aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/survivingdiabetes.com\/diagnosing-and-treating-diabetes-insipidus\/#Nephrogenic_diabetes_insipidus\" title=\"Nephrogenic diabetes insipidus\">Nephrogenic diabetes insipidus<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/survivingdiabetes.com\/diagnosing-and-treating-diabetes-insipidus\/#Central_diabetes_insipidus\" title=\"Central diabetes insipidus\">Central diabetes insipidus<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/survivingdiabetes.com\/diagnosing-and-treating-diabetes-insipidus\/#Autosomal_dominant_neurohypophyseal_diabetes_insipidus\" title=\"Autosomal dominant neurohypophyseal diabetes insipidus\">Autosomal dominant neurohypophyseal diabetes insipidus<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/survivingdiabetes.com\/diagnosing-and-treating-diabetes-insipidus\/#Gestational_diabetes_insipidus\" title=\"Gestational diabetes insipidus\">Gestational diabetes insipidus<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Nephrogenic_diabetes_insipidus\"><\/span>Nephrogenic diabetes insipidus<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Nephrogenic diabetes insipidus (NDI) is a renal disease where the kidneys do not produce enough urine to balance the fluid and electrolytes in the blood. This disease occurs when the kidneys do not respond to the antidiuretic hormone (AVP) signal and fail to produce concentrated urine. Nephrogenic diabetes insipidus may be present at birth or acquired.<\/p>\n<p>This is an autosomal recessive disease caused by pathogenic variants in the AQP2 gene. The resulting dehydration causes a number of problems with the bladder and the child's health. Infants with hNDI may have poor feeding habits and have low growth. They may be short or have other gastrointestinal issues. Although there is no cure for NDI, the symptoms can often be resolved with proper management.<\/p>\n<p>Patients with NDI should see a physician for a thorough diagnosis. This condition may be hereditary or secondary to certain conditions that impair the kidney's ability to concentrate fluid. Diagnosis of NDI involves monitoring urine osmolality changes after water deprivation. Thiazide diuretics may help treat this condition. A genetic disorder that affects the hypothalamus is also a risk factor for NDI.<\/p>\n<p>The diagnosis of NDI is made by evaluating the patient's urine output and signs of hypernatraemia. Several tests may be done to confirm the diagnosis. A water deprivation test and desmopressin test can help separate central from nephrogenic DI. Genetic testing can also confirm NDI if it is congenital. The most accurate diagnosis is based on a comprehensive assessment and treatment.<\/p>\n<p>Diagnosis is often difficult and expensive. The most common symptom is polyuria, but patients with early NDI may experience few symptoms. Early NDI can be compensated for by increased water intake. However, symptoms may worsen over time, leading to polyuria, nocturia, and a higher risk of death. Patients with severe NDI often exhibit neurologic symptoms, encephalopathy, and hyperkalaemia.<\/p>\n<p>ADH is a hormone produced in the pituitary gland that tells the kidneys to retain more water. This causes the urine to be dilute and the patient to become dehydrated. Nephrogenic diabetes insipidus can also be caused by a kidney disorder called HELLP syndrome. While there is no cure for nephrogenic diabetes insipidus, a medication called desmopressin can be used to treat it.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Central_diabetes_insipidus\"><\/span>Central diabetes insipidus<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The most common method for diagnosing central diabetes insipidus is through a test called a water deprivation study. During this study, the person with diabetes is given no water for 12 hours. The doctor will monitor the patient and inject a substance called vasopressin. This test is known as a gold standard in the diagnosis and treatment of diabetes insipidus. There are many different treatment options for diabetes insipidus.<\/p>\n<p>The ADH hormone is responsible for controlling the amount of water excreted in urine. When this hormone is deficient, the kidneys are unable to compensate for this, resulting in diluted urine. Because the body can't retain water properly, people with central diabetes insipidus must drink a lot of water to keep up with the rapid loss of fluid. This condition may be caused by surgery, injury to the pituitary gland, or inflammation. In rare cases, genetic factors can lead to this condition.<\/p>\n<p>In the majority of patients, the symptoms of central diabetes insipidus will resolve with treatment of the secondary cause. The condition is often characterized by polydipsia, hypotonic urine, and impaired renal concentrating ability. Acute episodes of central diabetes insipidus may be accompanied by complications, but they are rare and easily treated. Acute and life-threatening complications are rare in patients with CDI, and are unlikely to develop unless the condition is left untreated.<\/p>\n<p>Treatment for central diabetes insipidus involves injecting a synthetic hormone called desmopressin. The hormone is similar to vasopressin but has a longer half-life. It is administered orally, intranasally, or via injection. The dose of desmopressin is adjusted to maintain the body's water balance. Too much desmopressin may cause fluid retention or swelling.<\/p>\n<p>The most common type of central diabetes insipidus occurs when the brain fails to release enough ADH. This can be due to damage to the hypothalamus, a part of the brain that produces and controls the release of hormones. Many different things can damage the hypothalamus, including head injuries and surgery. It can also be caused by mental illness. If you suffer from this condition, you should seek treatment right away.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Autosomal_dominant_neurohypophyseal_diabetes_insipidus\"><\/span>Autosomal dominant neurohypophyseal diabetes insipidus<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Familial neurohypophyseal diabetes in the family is a rare, autosomal dominant disorder characterized by severe thirst, polydipsia, and polyuria. A defective neurosecretion of the antidiuretic hormone (AVP) results in the condition. The disease usually develops later in life and is usually caused by a mutation in the AVP gene. In children, AVP secretion appears to be normal at birth, but declines during early childhood. It is passed on in the autosomal dominant mode.<\/p>\n<p>Currently, only 62 mutations in the AVP-NPII gene have been identified. These mutations affect a single amino acid encoding neurophysin II (AVP). AVP is a precursor protein of the arginine vasopressin hormone, and NPII is the intracellular binding protein for AVP. There is no mutation in copeptin, which is another neurohypophyseal diabetes protein.<\/p>\n<p>Using a water deprivation test, a mother of a three-year-old boy was diagnosed with autosomal dominant neurohypophyseAL diabetes insipidus. DNA analysis and water deprivation tests confirmed the diagnosis of central DI in the son and his parents. AVP was analyzed using DNA analysis and found to have a novel mutation in exon 2 of the AVP-NPII gene. The mutation is expected to occur in three out of five clinical cases and has been described previously in familial neurohypophyseal DI in the United States16.<\/p>\n<p>The genetics of this disorder have not been well understood. There are no known treatments for it. It is difficult to diagnose and requires specialized care. Affected individuals may require invasive treatments like insulin and diuretics. However, a family history of autosomal dominant neurohypophyseal diabetes insipidus should be reviewed. The condition can be inherited from a mother or sister.<\/p>\n<p>In some cases, an x-ray scan is performed to rule out the presence of brain tumors. In this case, a &#8220;bright spot&#8221; is seen in the posterior sella and may represent vasopressin-containing neurons. The diagnosis of autosomal dominant neurohypophyseal diabetes insipidus can be made by the doctor and a family history can be analyzed.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Gestational_diabetes_insipidus\"><\/span>Gestational diabetes insipidus<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Polyuria and polydipsia are the hallmarks of DI, which is often nonspecific and may be associated with gestational state. Despite its prevalence, DI during pregnancy is frequently misdiagnosed. The changes in plasma sodium and osmolality in pregnant women may be caused by the presence of the hormone hCG, which influences the secretion of ADH and thirst thresholds. The osmolality of the blood decreases to 270mosmol\/kg, and the sodium concentration drops four to five meq\/L.<\/p>\n<p>The cause of gestational diabetes insipidus is not fully understood, but a placental enzyme may interfere with the kidneys' ability to process ADH. While the condition generally resolves after pregnancy, it can recur if the mother becomes pregnant again. The symptoms of gestational diabetes insipidus may be mild or intermittent, and doctors can prescribe a medication called desmopressin to control the symptoms.<\/p>\n<p>When suspected of gestational diabetes insipidus, a woman should undergo a water deprivation test. The patient was not dehydrated further after the treatment, but desmopressin was given. This medication reduced urine output and improved hypernatraemia. The doctor should recommend desmopressin to the woman if she experiences excessive thirst or frequent urination. If you suspect that you are suffering from gestational diabetes insipidus, consult a medical professional at Baptist Health and ask about your options.<\/p>\n<p>Gestational diabetes insipidus (GI) is an uncommon condition in pregnancy. It's caused by elevated vaso-pressinase levels. Although the condition is rarely fatal, it can cause significant harm to both mother and baby. Gestational diabetes insipidus has been linked to numerous complications during pregnancy, including premature birth. The following are some common symptoms of gestagenic diabetes insipidus:<\/p>\n<p>A water deprivation test is an effective diagnostic tool. During this test, a health care professional will assess the urine output, check your weight, and monitor blood and urine levels. The doctor may also administer man-made vasopressin or other medicines to reduce urine output. Another test for diagnosing gestational diabetes insipidus is called an MRI. An MRI uses radio waves to create pictures of the brain tissues and can show damage to the hypothalamus and pituitary gland.<\/p>\n<p><iframe style=\"margin: 0px auto; display: block;\" src=\"https:\/\/www.youtube.com\/embed\/75JrAx4hBC0\" width=\"447\" height=\"250\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A health care professional can diagnose diabetes insipidus by performing a water deprivation test. In this test, a health care professional will measure the amount of urine you produce while measuring your weight and blood sugar levels. He or she may also administer medicines such as man-made vasopressin or other substances. Another test is MRI, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1101,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47,49],"tags":[54,57],"_links":{"self":[{"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/posts\/1004"}],"collection":[{"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/comments?post=1004"}],"version-history":[{"count":2,"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/posts\/1004\/revisions"}],"predecessor-version":[{"id":1505,"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/posts\/1004\/revisions\/1505"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/media\/1101"}],"wp:attachment":[{"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/media?parent=1004"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/categories?post=1004"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/survivingdiabetes.com\/wp-json\/wp\/v2\/tags?post=1004"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}