Diabetes Insipidus

WHAT YOU SHOULD KNOW:

Diabetes Insipidus (Discharge Care) Care Guide

  • Diabetes insipidus (DI) is a disease where you cannot concentrate your urine. With DI, you urinate large amounts of dilute (watered down) urine. The amount of urine you make is controlled by chemicals in your body called hormones. Antidiuretic hormone (ADH), or L-arginine vasopressin (AVP), is made to decrease the amount of water lost in your urine. ADH is made in an area of your brain called the hypothalamus. When you have DI, your body does not make, or respond to ADH the way it should. You may have central diabetes insipidus (CDI) if your body has trouble making and releasing ADH. Nephrogenic diabetes insipidus (NDI) occurs when your kidneys do not respond to normal levels of ADH in your body. DI may be a short term illness, or you may have it for the rest of your life.

  • With DI, your body will not hold on to needed water, and you may become very ill. When your body loses too much water, you become dehydrated. You may feel very thirsty and have dry skin, headaches, and vision changes. Severe dehydration can lead to damage to your organs, such as your kidneys. You may need to have blood and urine tests, and a water deprivation test to diagnose your DI. You also may need a magnetic resonance imaging (MRI) test to check your brain for problems. Treatment includes replacing lost fluids, medicines, and diet changes. Treatment may help your body make and use ADH properly. Treatment may help prevent illness and organ damage from losing large amounts of body fluid. Treatment may save your life.

AFTER YOU LEAVE:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Medicine to treat CDI:

    • ADH replacement: You may be given medicines that increase the amount of ADH your body makes. The medicines help your body use the ADH to decrease your thirst and the amount you urinate.


  • Medicines to treat NDI:

    • Thiazide diuretics: These medicines may help your kidneys use ADH properly. The medicine also helps you urinate less and decrease the amount of fluid you lose with urination.

    • Potassium-sparing diuretics: This medicine helps your kidneys use ADH properly. The medicine helps decrease the amount of fluid you lose with urination and keep a normal potassium level.

    • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your primary healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

    • Prostaglandin synthetase inhibitors: These medicines work to decrease how much you are urinating.

Follow up visit information:

  • Ask your caregiver when to return for a follow-up visit. During your follow-up visit, tell your caregiver about any symptoms you are having. Also tell your caregiver if you feel you are having any side effects from your medicines. You may need blood and urine tests done to check if your treatments are working. You also may need an ultrasound to check the function of your kidneys and bladder. Ask your caregiver for more information about these and other tests you may need. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Daily weight:

Weigh yourself daily at the same time, on the same scale. Losing weight without trying can be a sign of fluid loss in your body. Checking your weight daily can help you see if you are at risk for DI.

Drinking liquids:

The fluids in your body that are lost through urination will need to be replaced. Men 19 years old and older should drink about three liters of liquid each day (almost 13 eight-ounce cups). Women 19 years and older should drink about 2.2 liters of liquid each day (almost 9 eight ounce cups). Your caregiver may tell you to only drink when you feel thirsty. Follow your caregiver's instructions about how much fluid you should drink.

Low salt diet:

You may need to decrease the amount of salt you eat. Eating a low-salt diet may help decrease the amount of water you lose from your body. Ask your caregiver for more information about a low-salt diet.

Genetic testing:

Genes are little pieces of information that tell your body what to do or make. The genes that control the way your body makes ADH may be damaged. Your body may not make enough ADH, or it may make ADH that does not work properly. The genes that control the way your kidneys respond to ADH may also be damaged. When this occurs, your body makes enough ADH, but your kidneys may not use it properly. If a genetic disease is causing your DI, other members of your family may also be at risk for the disease. Your caregiver may take blood samples from you and your family to test for any damaged genes. Ask your caregiver for more information about genetic testing.

Urination:

Urinate often, and try changing positions to make sure all of your urine is out of your bladder. This may help decrease your risk for kidney problems.

For more information:

Having diabetes insipidus may be life-changing for you and your family. You may need treatment for the rest of your life. Learning as much as you can about DI may help you cope better with treatment. Contact the following:

  • Endocrine and Metabolic Diseases Information Service
    National Institutes of Health
    6 Information Way
    Bethesda , MD 20892-3569
    Phone: 1- 888 - 828-0904
    Web Address: http://www.endocrine.niddk.nih.gov

CONTACT A CAREGIVER IF:

  • You have a dry mouth or cracked lips.

  • You are more tired than usual.

  • You have new headaches, or vision changes.

  • You have questions or concerns about diabetes insipidus, your treatment, or care.

SEEK CARE IMMEDIATELY IF:

  • You feel very thirsty all the time, and your thirst is waking you from sleep.

  • You are urinating large amounts of light yellow, or clear urine.

  • You are losing weight daily without trying.

  • You feel weak and dizzy, or have fainted (passed out).

  • You feel confused.

  • You have a seizure (convulsion).

  • You feel like your heart is beating harder than normal.

  • You have sudden chest pain or trouble breathing.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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