Diabetes insipidus
| Diabetes insipidus | |
|---|---|
| Synonyms | pituitary diabetes insipidus |
 |
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| Vasopressin | |
| Classification and external resources | |
| Specialty | Endocrinology |
| ICD-10 | E23.2 N25.1 |
| ICD-9-CM | 253.5 588.1 |
| OMIM | 304800 125800 |
| DiseasesDB | 3639 |
| MedlinePlus |
000377 Central000460 Congenital000461 Nephrogenic 000511 |
| eMedicine | med/543 ped/580 |
| MeSH | D003919 |
Diabetes insipidus (DI) is a condition characterized by excessive thirst and excretion of large amounts of severely dilute urine, with reduction of fluid intake having no effect on the concentration of the urine.
There are different types of DI, each with a different set of causes. The most common type in humans is the neurological form, called central DI (CDI), which involves a deficiency of arginine vasopressin (AVP), also known as antidiuretic hormone (ADH). The second common type of DI is nephrogenic diabetes insipidus (NDI), which is due to kidney or nephron dysfunction caused by an insensitivity of the kidneys or nephrons to ADH. DI can also be gestational, or caused by alcohol or some types of drug abuse. DI should not be confused with nocturia.
Although they have a common name, diabetes mellitus and diabetes insipidus are two entirely separate conditions with unrelated mechanisms. Both cause large amounts of urine to be produced (polyuria). However, diabetes insipidus is either a problem with the production of antidiuretic hormone (central diabetes insipidus) or kidney's response to antidiuretic hormone (nephrogenic diabetes insipidus), whereas diabetes mellitus causes polyuria via a process called osmotic diuresis, due to the high blood sugar leaking into the urine and taking excess water along with it.
The number of new cases of diabetes insipidus each year is 3 in 100,000. Diabetes insipidus usually starts in childhood or early adulthood and affects men more commonly than women. The term "diabetes" is derived from the Greek word meaning siphon.
Excessive urination and extreme thirst and increased fluid intake (especially for cold water and sometimes ice or ice water) are typical for DI. The symptoms of excessive urination and extreme thirst are similar to what is seen in untreated diabetes mellitus, with the distinction that the urine does not contain glucose. Blurred vision is a rarity. Signs of dehydration may also appear in some individuals, since the body cannot conserve much (if any) of the water it takes in.
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