Diabetes Insipidus Diagnosis & Treatments



Water deprivation test – this is meant to check urine production in the body after depriving water intake for a few hours. A person with positive diabetes insipidus would pass pale and watery urine despite being deprived of drinking water for several hours while a normal person would pass only very little concentrated urine. During this test, the person might also be checked for ADH levels in the blood through a blood test. Tests might also be carried out for levels of sugar, calcium and potassium in blood and urine. A diabetes insipidus person would have high water levels in the urine and lower levels of all other substances. A high sugar level in urine would reflect of diabetes mellitus and not diabetes insipidus.

Anti diuretic hormone test – This test follows the water deprivation test. The patient is injected with a small dose of ADH to see the body’s reaction to it and also to identify the type of diabetes insipidus affecting the person. If the dose leads to reduction or stopping of urine production, it means the person suffers from ADH deficiency and has cranial diabetes insipidus. However, in case the urine production does not reduce, it means there is no ADH shortage but it is a kidney malfunctioning which is causing the nephrogenic diabetes insipidus.

MRI Scan – Magnetic resonance imaging (MRI) might be advised to identify the abnormality in the hypothalamus or the pituitary gland of a person suffering from cranial diabetes insipidus, so that the abnormality can be treated before treating the diabetes condition.

TREATMENTS


The aim here is to reduce the urine production in the affected patients to regulate the water level in the body.

How to Treat cranial diabetes insipidus
For milder cases in which one produces 3-4 litres of urine in 24 hours, condition can be controlled simply if you increase the water intake and keep the body hydrated.

For more severe cases, drinking excess water is not enough and needs to be treated with Desmopressin which takes up the job of ADH. Desmopressin can be taken as a nasal spray called DDAVP or desmospray, to be sprayed into the nose couple of times a day. It gets absorbed quickly into the bloodstream. You also have the option of taking it as DDAVP tablet, prescribed if the patient develops a cold and cannot use the nasal spray. The tablets are less effectively absorbed into the blood and thus might have to be taken in increased dosages.

Desmopressin is quite safe in its use and hardly has any sidee effects, however, the dosage and fluid intake needs monitoring to maintain body water balance. Excess Desmopressin dose or increased fluid intake could cause headaches, dizziness, bloated feeling, hyponatraemia (dangerously low sodium levels in blood) and extreme situations can lead to fits and coma. So it is advised to stick to the advised dosage and drink fluids only when thirsty and visit the physician for regular 1-3months check-ups.

How to Treat Nephrogenic diabetes Insipidus
In case the condition is due to a medication like tetracycline or lithium, your physician might replace it with another drug, however, please take professional advice before doing so. Keeping the body hydrated with water and fluids are important.

In milder forms, this condition can be treated by having a low salt and low protein diet so kidneys produce less urine. Please take medical advice so you can reduce consumption of protein and salt rich foods like meats, processed foods, nuts and eggs.

In severe cases, the condition can be controlled by taking prescribed medication to reduce the urine production by the kidneys. This is generally a diuretic called hydrochlorothiazide which usually increases urine production, but in a nephrogenic diabetes insipidus condition it works in an opposite way to reduce the production of urine.

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