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Diabetes Insipidus: A Different Type of Diabetes Diabetes insipidus is a rare type of diabetes that most people don't know about. Type 1 and Type 2 Diabetes, the most prevalent and recognizable forms of diabetes, involve the body's inability to maintain normal glucose levels in the blood, usually due to a lack of insulin. In diabetes insipidus, the body lacks the anti-diuretic hormone vasopressin (ADH). Because of the absence or inaction of ADH or the failure of the kidneys to respond to ADH, the kidneys are rendered unable to concentrate urine. This results in large amounts of diluted urine being continuously excreted into the bladder, causing frequent urination. Diabetes insipidus (DI) can be transient, as in gestational DI (which occurs during pregnancy) or permanent, such as in neurogenic or nephrogenic DI. Neurogenic DI occurs in people who, for any number of reasons, have a compromised hypothalamus. Nephrogenic DI occurs when the kidneys do not respond to the presence of ADH due to genetic factors. Symptoms and Side Effects of DI The most prevalent and problematic symptom of DI is a large increase in the kidney's volume of urine output. This urine is extremely diluted because the kidneys are unable to reabsorb excess water during the filtering process. This, in effect, turns the kidney's "spigots" on full blast, as they try to filter normal amounts of body metabolites without the water-conserving properties of ADH. While at best inconvenient, this condition can also present serious medical problems, especially when drinking water may be temporarily unavailable, leading to severe and rapid dehydration. Another potentially serious side effect of DI is hypercalcemia (high calcium concentration) and hypokalemia (low potassium concentration), which can cause dangerous cardiac arrhythmias. Both hypercalcemia and hyperkolemia occur due to the sheer volume of water being processed as the kidneys try to filter out all metabolites. Instead of retaining water and necessary nutrients, the body filters out too much potassium. The potassium-to-calcium ratio is vital to muscle and nervous tissue function. As a result, any imbalance can cause serious cramping of the muscles, especially the cardiac muscle tissues that are vital to life. Treatments and Cures for DI The sheer inconveniences of needing to urinate often can be debilitating. Road trips, sporting events, religious services and work are all adversely affected by frequent urination and by the anxiety that arises from embarrassment. Transient episodes of DI, such as those seen in gestational DI in expectant mothers, can be treated with pharmacological ADH (vasopressin) therapy. Because vasopressin cannot be given orally, subcutaneous injections (injections given under the skin) must be given until the episode subsides. If, as in the cases of nephrogenic and neurogenic diabetes insipidus, frequent injections of vasopressin are not a viable long-term therapy, ADH derivative nasal sprays are available to reduce the frequency of urination. The rarity of DI may be the reason that some cases can be treated only with surgery on the hypothalamus and pituitary glands. For those who suffer from diabetes insipidus, it is important to find out exactly what is causing the problem so that appropriate treatments and therapies can be implemented. Often, the effects can be minimized or reversed to some extent, helping the DI patient lead a close to normal life. As with Type 1 and Type 2 Diabetes, early diagnosis can prevent life-threatening dehydration episodes and provide the necessary time and medical assistance to help the patient cope with this rare form of diabetes.

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