Diabetes Insipidus

GENERAL INFORMATION:

What is it? Diabetes (di-uh-b-tees) insipidus (in-sip-ih-dus) is also called DI. It happens when the pituitary (puh-to-uh-tair-e) gland in the brain does not make enough of a hormone. This hormone is called antidiuretic (an-ti-di-u-reh-tik) hormone (ADH). It is needed to control the amount of water in your body. Diabetes insipidus can also happen if the kidney is unable to do its job because it cannot respond to the ADH. DI is a serious illness that can usually be treated. You may need to take medicine for the rest of your life. Without treatment, you could die.

Causes: It is not known what causes DI but the following are the possible causes of DI.

• A brain aneurysm (an-yer-is-um) which is a weak part of an artery wall that sticks out like a little balloon.
  
  
• A brain infection.
  
  
• A tumor (growth) in the pituitary gland. This growth may or not be cancer.
  
  
• A tumor in the brain that puts pressure on the pituitary gland.
  
  
• A stroke in the pituitary gland.
  
  
• Compulsive, excessive fluid intake.
  
  
• Bleeding inside the skull (the bony part that covers the brain).
  
  
• Family history of DI. This is rare and usually starts during infancy.
  
  
• Head injury that damages the pituitary gland.
  
  
• Kidney disease.
  
  
• Surgery on the pituitary gland may cause the temporary type of DI, which lasts for approximately 14 days.

Signs and Symptoms:

• Desire to drink large amounts (12 to 60 soda pop can size) glasses of cold or iced fluids every day.
  
  
• Dry hands.
  
  
• Having constipation (kon-stih-pay-shun). This means it is hard to have a bowel movement (BM).
  
  
• Passing large amounts of urine that is clear in color.

Care: Treatment for DI depends upon what is causing the problem. You may need to go into the hospital for further care. Your caregiver may suggest one or more of the following tests or treatments.

• A complete medical history and examination.
  
  
• Basic medical tests, such as blood and urine tests.
  
  
• Computerized tomography (tuh-mah-gruh-fee) scan, which is also, called a "CT" or "CAT" scan. A special x-ray machine uses a computer to take pictures of your brain. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the brain and blood vessels in your head show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
  
  
• Daily weights to find out how much body fluid you have gained or lost.
  
  
• Dehydration (d-hi-dra-shun) test.
  
  
  • This is a urine and blood test to learn how much ADH is in your body. You are not able to drink fluids for 3 to 6 hours. Your urine is collected every hour for up to 6 hours while you are not drinking. After the 3rd hour, antidiuretic hormone medicine is sprayed into your nose. You may get this medicine as a shot.
    
    
  • Samples of blood and urine are then taken to measure the amount of ADH in your body. Your urine will be tested for sugar to see if you have Diabetes Mellitus (sugar diabetes). It will also be tested to determine the concentration (how clear or how dark) the urine is. This test will also help your caregiver determine how well your medications are working.
  
  
• Intake and output measurement, which keeps track of liquids taken in and passed out of the body. This helps caregiver know how much body fluid you have gained or lost.
  
  
• MRI: This test is also called magnetic resonance (reh-zuh-nuns) imaging. During the MRI, 3-D (three-dimensional) pictures are taken of your brain. Caregivers use these pictures to look for any signs of a tumor in your pituitary gland.
  
  
• Surgery. You may need brain surgery if a tumor putting pressure on the pituitary gland is the cause of your DI.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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