Diabetes Insipidus (DI) creates the opposite effect of diabetes millitus, which is Type I or Type II diabetes. Diabetes millitus creates conditions within the body that make it difficult to deal with sugars, glucose, and other similar substances. It creates urine that is very sugary and cloudy. In comparison, diabetes insipidus creates urine that is clear, dull, and lacking of substance because there is a disruption in how the kidneys extract water and filter waste.
Think of diabetes insipidus like this. When you drink a lot of water during the day and feel the need to go to the bathroom, the color of the urine is often dependent on how many fluids have been consumed. Heavy water consumption translates into clear urine. A lack of fluid consumption results in urine that is dark yellow in color.
For those who are suffering from diabetes insipidus, their urine is always pale and clear. This is because their Vasopressin, which is an anti-diuretic hormone (ADH), isn’t doing the job it should be doing. When this disease is present, there are some telltale symptoms that can let someone know that DI is a possibility.
The Most Common Symptom of Diabetes Insipidus: Thirst
Sometimes diabetes insipidus and diabetes mellitus are confused as similar diseases because of the common symptom they share: thirst. For DI, the cause of thirst is because the ADH levels are unable to respond accordingly to the body’s needs for some reason. It could be because there is an overall lack of the hormone present or it could be because the kidneys have stopped responding to the hormone for some reason.
Thirst happens because the body needs to purse the wastes that are present in the body. Because wastes are always being filtered out of the blood stream by the kidneys, there is a constant need to flush that waste out. The urge to drink something can be very mild or severe and ongoing depending on the level of disease development within the body.
Excessive Urination Is Also a Common Symptom
When people consume more fluids, then there will generally be more urine that is created. For those with DI, there is a constant need to consume fluids because of the feelings of dehydration. Depending on how much a person is actually drinking to replace the fluids that are being pulled out of the body, a lot of diluted urine can be produced as a result.
In mild cases of DI, a person may have a urine output that is equal to about 2 liters per day. That’s actually within the normal range of the general population, which is 1.5-2.5 liters of urine per day.
With severe cases of diabetes insipidus, however, a person may find themselves producing about 20 liters of urine every day when they are drinking replacement fluids every time they are thirsty. That’s enough urine to fill a 5 gallon bucket to overflowing every day.
Because of this need to constantly urinate, people with DI will typically wake up several times per night with an urgent need to use the bathroom. They may also find themselves frequently visiting the toilet with a full, painful bladder throughout the day.
The Signs and Symptoms of Diabetes Insipidus in Children
Because diabetes insipidus can be passed along as a genetic disorder, newborns, toddlers, and children may also be experiencing the signs and symptoms of DI. Because children do not always communicate these symptoms or find them to be problematic, an observation of their behavior is often necessary to determine if they may be suffering from DI.
The most common sign of a child having diabetes insipidus is bed-wetting that is frequent despite changes in fluid consumption. If a child is not consuming fluids before bed and is still bed-wetting, then this issue should receive a doctor consultation. Older children may follow the pattern of adults with DI and be awake frequently throughout the night with a frequent urge to urinate.
In younger children, toddlers, and newborns, the signs and symptoms of diabetes insipidus can be subtle. Look for the following issues.
1. Inconsolable crying.
If your newborn or infant will not settle down and everything has been tried, then DI may be a possibility. This is especially true if the child seems to suffer from seemingly random bouts of unexplained fussiness.
2. Very wet diapers.
Every infant and newborn is going to have wet diapers. Some of them are going to be heavier than others, especially the diaper that comes after their bottle. When DI is present, however, there can be so much urine that the diaper may not hold it all. This will occur frequently throughout the day.
3. Flu-like symptoms.
Children who have DI may have symptoms that are reminiscent of influenza. A fever is common, as is vomiting or diarrhea that does not seem to improve. Follow your doctor’s advice about when to seek treatment for these symptoms.
4. Dry skin.
If you do not live in a dry air environment and your child seems to constantly need lotion to prevent their skin from flaking, then this can be a symptom of diabetes insipidus. When there is a dry air environment and your child needs more lotion than you or other children, then this may also be a sign or symptom of DI.
5. Delayed growth.
Children with diabetes insipidus often have delayed growth compared to their peers because their bodies are constantly trying to purge liquids. This delayed growth may be in height, in weight, or both. If your child has been following a growth curve and then begins to fall beneath it, then DI may be considered as a possibility.
What Are the Dangers of Diabetes Insipidus?
The primary danger of DI is the development of dehydration. If you’ve ever had several cups of coffee or two strong energy drinks in a row, then you’ve experienced a similar feeling to what those with DI feel when they don’t drink enough water. Dizziness, nausea, muscle twitches, and unexplained pain throughout the body may happen. People feel tired all of the time, lethargic, and will often have a dry, cottony mouth. Their lips may also be chapped, cracked, and dry as well.
There are also many substances that help to regulate how the body functions on a daily basis. Called “electrolytes,” these minerals are responsible for nerve function and muscle function. Calcium, magnesium, sodium, and potassium are all electrolytes, as is chloride. Because of the fluid excretion that occurs with DI, it becomes very easy for these minerals to get out of balance and begin to cause symptoms that may be bothersome.
The symptoms of an electrolyte imbalance can be extremely varied because having too much or too little of just one mineral can create the imbalance. Muscle spasms and twitches, unexplained muscle cramping, weakness, blood pressure changes, and even irregular heartbeats can all occur from an electrolyte imbalance.
When Should a Doctor Be Seen?
Even if the signs and symptoms of diabetes insipidus are not bothersome, an appointment with a doctor should be made if the two most common symptoms of DI are frequent and ongoing: excessive thirst and excessive urination. There may be other underlying medical conditions that require treatment that could be more severe.
Diabetes insipidus has a name that causes many to worry, but it is a relatively mild disease when compared to other issues that people face on a daily basis. Many people can control their signs and symptoms through better lifestyle management. Mild cases of DI may not require any medical intervention at all.
Sometimes mild cases of DI can be relieved by simple lifestyle changes. Better foods, fluid availability, and exercise management outside of hot environments can help to prevent the signs and symptoms of diabetes insipidus. Even when it is under control, however, it is important to have a DI diagnosis as part of a complete medical history in case there are further developments which may need to be tracked later on.
How Is a DI Diagnosis Confirmed?
If a person is experiencing extreme thirst or excessive urination, then a full medical workup will generally be ordered. After the initial interview and a physical examination, blood and urine tests will typically be ordered. For women, a pregnancy test may also be ordered if of child-bearing age. Depending on the results, the underlying condition will be treated [such as an electrolyte imbalance] or medications to control bothersome symptoms may be ordered.
In severe cases, an IV solution may also be ordered to help replenish missing fluids. Sometimes persistent dehydration can mimic the signs and symptoms of diabetes insipidus, so a doctor suspecting this issue may re-examine a patient after fluid absorption has improved.
When the signs and symptoms of diabetes insipidus are bothersome, however, there are medical options available for treatment. The treatment plan is to control the feelings of excessive thirst while working to treat any underlying condition that may exist.