Symptoms of Diabetes Insipidus
Diabetes insipidus (DI) is a rare disorder of water metabolism. It is caused by a lack of, or nonresponse to, the antidiuretic hormone (ADH) vasopressin, which controls water balance by concentrating urine. The condition is characterized by excessive amounts of very dilute urine output, fluid intake and often thirst.
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Causes of diabetes insipidus
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Diabetes insipidus may result from any one of the following:
Inadequate secretion of arginine vasopressin (AVP) or ADH, known as central or neurogenic DI
Impaired renal responsiveness to AVP, known as nephrogenic DI
Increased water intake or primary polydipsia, known as dipsogenic DI
Polyuria
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One of the cardinal symptoms of DI is polyuria. The urine volume of patients varies between a few liters in partial DI to 20 liters in complete DI. Patients also complain of interrupted sleep at night because of polyuria. This may lead them to limit their fluid intake, which then may lead to intolerable thirst. Thus, the patient's life becomes miserable and lies between "the water jug and the lavatory." Polyuria also results in bed-wetting in some patients.
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Polydipsia
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Another characteristic of DI is excessive thirst and often a craving for ice cold water.
Dehydration
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Patients could become seriously dehydrated if this condition is left untreated. As a result, they may have dry skin, dry tongue and sunken eyes.
Hyperosmolality
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Hyperosmolality may develop rapidly in patients. Symptoms include irritability, mental dullness, ataxia (lack of coordination while performing voluntary movements), hyperthermia and coma, if access to water is interrupted.
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References
- Medicine Prep Manual; K. George Mathew; 1994
- Manual of Practical Medicine; R. Alagappan; September 1998
- Textbook of Medicine; P.C. Das; June 1988
