When you think of the word diabetes, what comes to mind?
Maybe you think of insulin injections, since type 1 diabetes occurs as a result of the body being unable to create insulin. Or perhaps you think of controlling high blood sugar through a low glycemic index diet?
What if I told you that the name diabetes has nothing to do with blood sugar control or insulin injections? Let me explain…
What is Diabetes Insipidus?
In general, diabetes is a term that causes the body to produce a large amount of urine. Excessive urination is a symptom that is highly characteristic of all types of diabetes, especially diabetes insipidus. It is a chronic endocrine disorder that is distinctive of intense thirst—known as polydipsia. In other words, this form of diabetes has absolutely nothing to do with blood sugar or insulin.
Causes of Diabetes Insipidus
There are two main types of diabetes insipidus—nephrogenic diabetes insipidus and central diabetes insipidus (neurogenic diabetes insipidus).
Central diabetes insipidus results from a lack of antidiuretic hormone (ADH)—also called vasopressin—it’s basically a hormone that promotes the retention of water by the kidneys. It can be characterized by pituitary gland damage caused by inflammation, surgery, a tumor, a head injury, or an illness such as meningitis. The cause is usually genetic with children. Also, in some cases the cause of central diabetes insipidus is not known.
On the other hand, your body will often make enough vasopressin with nephrogenic diabetes insipidus; however, your kidneys will not respond to the ADH due to a kidney tubules defect. The cause may be due to a chronic kidney disorder or an inherited genetic disorder from an X-linked trait that will affect the arginine vasopressin (AVP) receptor 2 gene. Nephrogenic diabetes insipidus is also thought to affect men more than women; however, women can pass the gene that causes the disease to their children.
Certain drugs can lead to nephrogenic diabetes insipidus, including lithium and a tetracycline antibiotic called demeclocycline. Other disorders can also make the kidneys sensitive to ADH such as autosomal dominant polycystic kidney disease, sickle cell nephropathy, hypercalcemia (high calcium levels), low potassium levels, amyloidosis, Sjogren syndrome, pyelonephritis, Bardet-Biedl syndrome, chronic hypokalemic nephropathy, release of obstructing periureteral fibrosis, and nephronophthisis and medullary cystic kidney disease complex, and certain cancers like sarcoma and myeloma.
Gestational diabetes insipidus is a type of diabetes insipidus that happens during pregnancy. It also occurs when an enzyme made by the placenta destroys the vasopressin before the baby is born. Primary polydipsia is another condition also called psychogenic polydipsia or dipsogenic diabetes insipidus. The condition can cause a large amount of diluted urine. This form of diabetes insipidus is caused by excessive intake of fluids rather than an issue with damage or vasopressin production. Prolonged excessive water intake can suppress ADH and cause kidney damage, and therefore the body cannot concentrate urine. Other causes or primary polydipsia include mental illness and abnormal thirst.
Symptoms of Diabetes Insipidus
As mentioned, excessive thirst and frequent urination are the main symptoms of diabetes insipidus.
Other symptoms related with diabetes insipidus include:
- Colorless urine instead of pale yellow
- Frequent desire to wake up throughout the night to urinate
Young children and infants will also experience unusually:
- Wet diapers
- Delayed growth
- Weight loss
- Dry skin with cool extremities
- Inconsolable crying or unexplained fussiness
Others will also experience dehydration, and if the person loses too much water, they may also show signs of irritability, muscle pains, lethargy, and unexplained weakness.
How Is Diabetes Insipidus Diagnosed?
There are a number of ways diabetes insipidus is diagnosed. For instance, a fluid deprivation test can help differentiate between the types of diabetes insipidus, including an ADH production defect (central diabetes insipidus), a defect in the kidney response to ADH (nephrogenic diabetes insipidus), or excessive fluid intake (primary polydipsia). The test will measure changes in urine output and urine composition when fluids are withheld. Sometimes blood ADH levels are also measured during a fluid deprivation test.
Diabetes insipidus is also sometimes determined when urine is less concentrated in a urinalysis test. A magnetic resonance imagining (MRI) of the brain is also considered a non-invasive test that can help detect pituitary gland abnormalities related to central diabetes insipidus. Genetic screening may also be suggested in those with a family history of diabetes insipidus.
Without diabetes insipidus treatment, the condition can lead to fatigue, weight loss, increased heart rate, low body temperature, chronic dehydration, consistent headaches, low blood pressure, brain damage, and kidney damage.
The most common conventional treatments will depend on the type of diabetes insipidus:
Central diabetes insipidus
Treatment is usually desmopressin—a synthetic replacement for vasopressin that reduces urine production. People should only take desmopressin as needed since taking excessive desmopressin can result in low sodium levels in the blood and large amounts of water retention. Low sodium symptoms include nausea, confusion, lethargy, and possibly seizures.
Nephrogenic diabetes insipidus
Desmopressin is not a treatment option since the kidneys are not functioning properly from ADH. The main treatment options include water intake to avoid dehydration, a low-salt diet to lower the urine made by your kidneys, and a low protein diet. If symptoms don’t stop, drugs are often given to reduce urine output, including thiazide diuretics, amiloride, and non-steroidal anti-inflammatory drugs (NSAIDs).
Gestational diabetes insipidus
Desmopressin is also used to treat gestational diabetes insipidus. The noted side effects of desmopressin include nausea, belly pain, headaches, vomiting, sudden face redness and a slight increase in blood pressure. In rare cases gestational diabetes insipidus is caused by a thirst mechanism abnormality, and in these cases desmopressin is not prescribed.
The main diabetes insipidus treatment method involves reducing your fluid intake. However, when mental illness causes primary polydipsia, treating the mental illness may relieve the primary polydipsia symptoms.
Natural Treatments for Diabetes Insipidus
There are natural treatments available for diabetes insipidus, especially when it comes to diet changes. The best natural approach for diabetes insipidus treatment should be to address the symptoms of frequent urination and excessive thirst. The following are some natural diet changes that can go a long way:
The diabetes insipidus diet
This is a low-salt diet and low-protein diet. It is thought that eating salty foods will enhance thirst associated with diabetes insipidus. Excessive salt intake creates instant thirst that causes you to drink more than necessary. All salty snacks and foods should be eliminated from the diet such as pretzels, peanuts, potato chips, and condiments. Since people with diabetes insipidus may urinate more frequently, avoidance of salty foods helps prevent the problem from getting worse.
Although a low protein diet is also recommended, it is believed that it may lead to nutritional deficiencies. Overall, the diet should contain mostly nutrient-dense whole foods with plenty of water-heavy fruits and vegetables. The best water-based foods to include as part of the diabetes insipidus diet includes cucumbers, zucchini, radishes, blueberries, strawberries, sweet bell peppers, red cabbage, and dark green leafy vegetables such as spinach and kale.
Replenish with adequate fluids
It is important for those with nephrogenic diabetes insipidus to increase their water consumption. However, chronic water intake can be an issue with polydipsia and kidney damage. It is important for diabetes insipidus patients to drink enough liquids to replace their urine losses and to relieve excessive thirst. It is recommended that fluid replacement not exceed 500 ml to 750 ml per hour. It is a good idea to carry a water bottle with you to prevent dehydration associated with diabetes insipidus.
Vitamin D supplementation
In a published case study in the journal Archives of Diseases in Childhood, a patient with nephrogenic diabetes insipidus also featured low levels of vitamin D3 (cholecalciferol). It makes sense then that vitamin D3 supplementation would help balance the deficiency in those with nephrogenic diabetes insipidus.
Also Read : Why Women Need More Vitamin D
Diabetes insipidus natural treatments also include herbal remedies. In particular plantain, catechu, and black sesame seed are considered effective for excessive urination. Herbal remedies that are often used for excessive thirst include quince fruit seeds, Indian barberry, green cardamom peel, coriander seeds, lemon juice, tamarind pulp, mango tree young shoots, neem leaves, cucumber seeds, cloves, nutmeg, sandalwood, turmeric, holy basil, fennel seed, and mint leaves.
There are also some homeopathic remedies that can help relieve diabetes insipidus naturally. For instance, the remedy uranium nitrate can help treat excessive thirst and frequent urination related with diabetes insipidus. Phosphoric acid is also considered when the person with diabetes insipidus experiences symptoms of nervousness, anxiety, worry, and grief. Other appropriate homeopathic remedies for diabetes insipidus include causticum, silicea, strophanthus, phosphorus, lactic acid, and bryonia.
Lifestyle Changes for Diabetes Insipidus
There are key lifestyle changes that can help patients with diabetes insipidus, including:
- Avoiding processed foods: Avoiding processed foods reduces your intake of sodium, and the chemicals and preservatives associated with packaged food items.
- Removing caffeine from the diet: Try removing caffeine from the diet, especially coffee and carbonated soft drinks. Caffeine can also be found in chocolate, black tea, energy drinks, and over-the-counter drugs such as aspirin.
Final Thoughts on Diabetes Insipidus Treatment
Although nephrogenic diabetes insipidus and central diabetes insipidus can be difficult to treat, there are options that successfully treat the condition. To recap, the dietary options include a low-salt and low-protein diet. It is also important to consume a nutrient dense diet that is high in vegetables and fruits. It is a good idea to drink more water in the treatment of diabetes insipidus, especially with central diabetes insipidus.
Sources for Today’s Article:
Zelman, M., et al., Human Diseases: A Systemic Approach (Upper Saddle River: Pearson Education, 2015), 273.
“Treatments and drugs,” Mayo Clinic web site, March 14, 2013; http://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/basics/treatment/con-20026841.
“Diabetes insipidus,” Mayo Clinic web site, March 14, 2013; http://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/basics/causes/con-20026841.
Chapman, I.M., “Central Diabetes Insipidus (Vasopressin-Sensitive Diabetes Insipidus),” Merck Manual Professional Version web site; http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/pituitary-disorders/central-diabetes-insipidus, last accessed October 20, 2015.
McMillan, J.I., “Nephrogenic Diabetes Insipidus,” Merck Manual Professional Version web site; http://www.merckmanuals.com/professional/genitourinary-disorders/renal-transport-abnormalities/nephrogenic-diabetes-insipidus, last accessed October 20, 2015.
“Homeopathy for Diabetes,” Hpathy.com, May 16, 2014; http://treatment.hpathy.com/homeo-medicine/homeopathy-diabetes/.
Katzir, Z., et al., “Nephrogenic diabetes insipidus, cystinosis, and vitamin D,” Archives of Disease in Childhood, 1988; 63(5): 548-550.
Khardori, R., “Diabetes Insipidus Treatment & Management,” Medscape web site; http://emedicine.medscape.com/article/117648-treatment, last accessed October 20, 2015.
“Natural Tips to Quench Excessive Thirst,” Natural Fitness Tips web site; http://www.nftips.com/2014/06/natural-tips-to-quench-excessive-thirst.html, last accessed October 20, 2015.
“Diet for Diabetes Insipidus Insipidus,” Diabetes Insipidus web site; http://diabetesinsipidus.org/diet-for-diabetes-insipidus, last accessed October 20, 2015.