Learn About Diabetes Insipidus (DI)
Diabetes insipidus (DI) is an uncommon condition in which the kidneys are unable to prevent the excretion of water.
DI is not the same as diabetes mellitus types 1 and 2. However, untreated, both DI and diabetes mellitus cause constant thirst and frequent urination. People with diabetes mellitus have high blood sugar (glucose). Those with DI have normal blood sugar levels, but their kidneys are not able to balance fluid and salt (sodium) in the body.
During the day, your kidneys filter all of your blood many times. Normally, most of the water is reabsorbed, and only a small amount of concentrated urine, relative to the volume of blood, is excreted. DI occurs when your kidneys cannot concentrate the urine normally, and a large amount of dilute urine is excreted.
The amount of water excreted in the urine is regulated by antidiuretic hormone (ADH). ADH is also called vasopressin. ADH is produced in a part of the brain called the hypothalamus. It is then stored and released from the pituitary gland. This is a small gland just below the base of the brain.
DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. Nephrogenic means related to the kidney.
Central DI is uncommon. It can be caused by damage to the hypothalamus or pituitary gland as a result of:
- Genetic problems
- Head injury (common cause)
- Infection in the brain
- Problem with the ADH-producing cells due to an autoimmune disease
- Loss of blood supply to the pituitary gland
- Surgery in the area of the pituitary gland or hypothalamus (most common cause)
- Tumors in or near the pituitary gland
Nephrogenic DI involves a defect in the kidneys. As a result, the kidneys do not respond to ADH. Nephrogenic DI is uncommon. Nephrogenic DI may be caused by:
- Certain medicines, such as lithium
- Genetic problems
- High level of calcium in the body (hypercalcemia)
- Kidney disease, such as polycystic kidney disease
Symptoms of DI include:
- Excessive thirst that may be intense or uncontrollable, usually with the need to drink large amounts of water or craving for ice water
- Excessive urine volume
- Excessive urination, often needing to urinate every hour throughout the day and night
- Very dilute, pale urine
The cause of the underlying condition will be treated when possible.
Central DI may be regulated with desmopressin (also called DDAVP which has actions in the body like vasopressin). You may take desmopressin as an injection, a nasal spray, or tablets.
If nephrogenic DI is caused by a medicine, stopping the medicine may help restore normal kidney function. But after many years of use of some medicines, such as lithium, nephrogenic DI can be permanent.
Hereditary nephrogenic DI and lithium-induced nephrogenic DI are treated by drinking enough fluids to match urine output. Medicines that lower urine output also need to be taken.
Nephrogenic DI is treated with anti-inflammatory medicines and diuretics (water pills).
3800 Reservoir Road Northwest PHC
Joseph Verbalis is an Endocrinologist in Washington, Washington, D.c.. Dr. Verbalis is rated as an Elite provider by MediFind in the treatment of Diabetes Insipidus (DI). His top areas of expertise are Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH), Diabetes Insipidus (DI), Neurohypophyseal Diabetes Insipidus, Osteoporosis, and Vagotomy.
St. Louis Children's Hospital
Bess Marshall is a Pediatric Endocrinologist in Saint Louis, Missouri. Dr. Marshall is rated as an Elite provider by MediFind in the treatment of Diabetes Insipidus (DI). Her top areas of expertise are Diabetes Insipidus (DI), Type 1 Diabetes (T1D), Neurohypophyseal Diabetes Insipidus, and Congenital Hyperinsulinism.
Reading Hospital Endocrinology & Diabetes Center Wyomissing
. Dr. Gabriely is rated as a Distinguished provider by MediFind in the treatment of Diabetes Insipidus (DI). His top areas of expertise are Low Blood Sugar, Hyperparathyroidism, Thyroid Cancer, and Anaplastic Thyroid Cancer.
The outcome depends on the underlying disorder. If treated, DI does not cause severe problems or result in early death.
If your body's thirst control is normal and you are able to drink enough fluids, there are no significant effects on body fluid or salt balance.
Not drinking enough fluids can lead to dehydration and electrolyte imbalance, which can be very dangerous.
If DI is treated with vasopressin and your body's thirst control is not normal, drinking more fluids than your body needs can also cause a dangerous electrolyte imbalance.
Contact your provider if you develop symptoms of DI.
If you have DI, contact your provider if frequent urination or extreme thirst returns after treatment.
Summary: The PHOENIX study aims to investigate whether oral estradiol valerate (EV) and ethinylestradiol (EE) can stimulate oxytocin (OXT) and neurophysin-1 (NP-1) release in humans. The goal is to assess their potential as a safe diagnostic stimulation test for oxytocin deficiency, particularly in patients with arginine vasopressin (AVP) deficiency.
Summary: This randomized, placebo-controlled, double-blind trial aims to investigate intranasal OXT as a novel therapeutical option in central diabetes insipidus (cDI) to improve psychological symptoms and socio-emotional functioning. Optionally, patients can present for additional assessments in sub-studies: * fMRI sub-study at day 14 (± 2 days) (one additional visit) * Social-stress sub-study at day 14 (...
Published Date: April 24, 2025
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Christ-Crain M, Thompson CJ, Verbalis JG. Posterior pituitary. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 8.
Soto-Rivera CL, Breault DT, Majzuob JA. Diabetes insipidus. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 596.
Verbalis JG. Disorders of water balance. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 15.
Verbalis JG. Posterior pituitary. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 206.