Diabetes Insipidus



What is Diabetes Insipidus?

Diabetis insipidus is caused when the posterior part of the pituitary gland fails to secrete adequate amounts of the antidiuretic hormone (or ADH) arginine vasopressin, which helps to control loss of water. It was first described as far back as 1794 when Frank spoke of it as a “long continued abnormality of increased nonsaccharine urine not caused by renal disease,” so distinguishing it from diabetes mellitus. However, a more acceptable definition, taken from the British Medical Journal, is: “A rare disease, characterized by polyuria and polydipsia, from lack of the antidiuretic hormone, arginine vasopressin.” Deficient hormonal secretion may occur at any age and in either sex, depending on how and when the cause of the disorder sets in. It may be due to damage to the hypothalamus or posterior lobe of the pituitary, or by tumors, benign or cancerous. Head injuries or brain operations may be incriminated.

Diabetes Insipidus Symptoms

Diabetes insipidus may occur slowly or suddenly. An intense thirst may take place, sometimes becoming intolerable, particularly if any attempt at restricting fluid is made. Children may suddenly start bedwetting for no obvious cause. Volumes of from four to 20 liters may be passed. Depending on the cause there may also be other nervous-system symptoms.



Diabetes Insipidus Treatment

This consists of the replacement of the deficient hormone – vasopressin. This must be given by intramuscular injection usually as vasopressin tannate in oil, once in every 24 – 48 hours. It seems an excellent product to which resistance, fortunately. rarely occurs. In an effort to simplify treatment, a search has been made in recent times for an oral product that will have a similar beneficial effect. Several oral agents, such as the thiazides or chlorpropamide, now appear to offer good results. Other promising agents are carbamazepine (better known as Tegretol, used in epilepsy) and clofibrate. used in persons with high blood cholesterol levels, and the oral diuretics (fluid pills). It is important that the patient understand that alcohol must not be taken with these drugs, for adverse effects might suddenly become apparent. The outlook for these patients is excellent, provided the underlying cause of the disorder does not produce its own problems.