diabetes insipidus

The diabetes insipidus - A rare condition that is characterized by excessive thirst and the passing of large quantities of dilute urine.

A person with diabetes insipidus may pass between five and 20 litres of urine every 24 hours, provided that this output is matched by a sufficient intake of water. If the lost water is not replaced, dehydration may occur, leading to confusion, stupor, and coma.

Diabetes insipidus usually results from a failure of the pituitary gland to secrete ADH (antidiuretic hormone), which normally regulates the amount of water excreted in the urine.This failure may be due to a disease of the pituitary gland, or may temporarily follow brain surgery. A rare form of the disease, called nephrogenic diabetes insipidus, is due to failure of the kidneys to respond to ADH.

Diagnosis mainly involves blood and urine tests. A doctor may measure output of urine over 24 hours. He or she may also measure urine output when fluid has been withheld for several hours; an affected person will continue to pass a large volume of urine. The person’s response to synthetic ADH may
also be tested; if the urine output remains high even after the person has taken ADH, this indicates the nephrogenic form of the disease.

Treatment of ADH-related diabetes insipidus is with desmopressin (synthetic ADH). Treatment of nephrogenic diabetes insipidus is by a low-sodium diet and thiazide diuretic drugs.


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