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Clinical Overview
Diagnosis and Treatment

Diabetes Insipidus

Clinical Overview
Reviewed by: Michael Fuller, MD

Diabetes indibidus (DI) is a disease in which a large amount of severely diluted urine is excreted regardless of fluid intake. It occurs when the kidney cannot concentrate urine as it should.

DI occurs in people who have a deficiency of antidiuretic hormone (ADH; also known as vasopressin), or in people whose kidneys are insensitive to ADH, or it may be induced by the diuretic drug conivaptan.

The main symptoms of DI are excessive urination and extreme thirst, especially for cold water, ice, or ice water. These symptoms are very similar to those of untreated type 1 and type 2 diabetes, except that the urine of type 1 and 2 patients doesn’t have the same sweet smell since it does not contain an excess of glucose. The excessive urination continues during the day and night, and may be accompanied by symptoms of dehydration, as the body often has difficulty retaining any of the water that is ingested.

In children, DI can cause appetite or eating disturbances, and may interfere with weight gain and normal growth. They may experience fever, vomiting and diarrhea. Adults may experience some of these symptoms as well, but they may also remain healthy for many years if they are able to keep their fluid intake up and avoid dehydration.

There are four types of DI:

  • Neurogenic DI, also known as central, hypothalamic, pituitary or neurohypophyseal DI, is caused by insufficient levels of ADH.

  • Nephrogenic, or vasopressin-resistant, DI is caused by insensitivity of the kidneys to ADH.

  • Dipsogenic is caused by abnormal thirst and excessive intake of water or other liquids.

  • Gestational DI is caused by insufficient levels of the ADH that occurs only during pregnancy.

    Last updated: Dec-10-07

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