Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you've had something to drink. It also leads you to produce large amounts of urine

1. Diabetes insipidus
PRESENTED BY:
MR: ABHAY RAJPOOT

2. INTRODUCTION
• Diabetes insipidus is an uncommon disorder that causes an
imbalance of fluids in the body. This imbalance makes the very
thirsty even if you've had something to drink. It also leads you to
produce large amounts of urine.
• In healthy individuals, when the bodily fluids are depleted, ADH
is released from the pituitary gland which prevents the excretion
of fluids from the body in the form of urine

3. DEFINITION
Diabetes insipidus is caused by abnormality in the functioning or
levels of antidiuretic hormone (ADH), also known of as vasopressin.
Manufactured in the hypothalamus and stored in the pituitary
gland, ADH helps to regulate the amount of fluid in the body.

4. CAUSES
• A hypothalamus gland that doesn't make enough ADH.
• A pituitary gland that doesn't release enough ADH into the
blood.
• Damage to the hypothalamus or pituitary gland during
surgery or radiation therapy.
• Brain injury.
• Brain tumor

5. • Central diabetes insipidus. Damage to the pituitary gland or
hypothalamus from surgery, a tumor, a head injury or an illness can
cause central diabetes insipidus by affecting the usual production,
storage and release of ADH. An inherited genetic disease can also
cause this condition.
• Nephrogenic diabetes insipidus. Nephrogenic diabetes insipidus
occurs when there's a defect in the kidney tubules — the structures in
your kidneys that cause water to be excreted or reabsorbed. This
defect makes your kidneys unable to properly respond to ADH.

6. • Gestational diabetes insipidus. Gestational diabetes insipidus is rare.
It occurs only during pregnancy when an enzyme made by the
placenta destroys ADH in the mother.
• Primary polydipsia. Also known as dipsogenic diabetes insipidus, this
condition can cause production of large amounts of diluted urine. The
underlying cause is drinking an excessive amount of fluids.

7. PATHOPHYSIOLOGY

9. SIGN AND SYMPTOMS

10. DIAGNOSTIC EVALUATION
History collection
Physical examination
Water deprivation test. While being monitored by a doctor and health care team, you'll be asked
to stop drinking fluids for several hours. To prevent dehydration while fluids are restricted, ADH
allows the kidneys to decrease the amount of fluid lost in the urine.
Magnetic resonance imaging (MRI).
Genetic screening

11. COMPLICATION
Dehydration
• Diabetes insipidus may lead to dehydration. Dehydration can cause:
• Dry mouth
• Changes in skin elasticity
• Thirst
• Fatigue

12. Electrolyte imbalance
Diabetes insipidus can cause an imbalance in electrolytes. Symptoms of
an electrolyte imbalance may include:
• Weakness
• Nausea
• Vomiting
• Loss of appetite
• Muscle cramps
• Confusion

13. MANAGEMENT
Treatment options for the most common types of diabetes
insipidus include:
• Central diabetes insipidus. If the condition is caused by an
abnormality in the pituitary gland or hypothalamus (such as a
tumor), the doctor will first treat the abnormality.
• Other medications may also be prescribed, such as indomethacin
(Indocin, Tivorbex) and chlorpropamide. These drugs can make
ADH more available in the body.

14. CONT….
Nephrogenic diabetes insipidus.
• Treatment with the drug hydrochlorothiazide (Microzide) may improve the
symptoms. Although hydrochlorothiazide is a type of drug that usually
increases urine output (diuretic), in some people it can reduce urine output
for people with nephrogenic diabetes insipidus.
Gestational diabetes insipidus. Treatment for most people with gestational
diabetes insipidus is with the synthetic hormone desmopressin.
Primary polydipsia. There is no specific treatment for this form of diabetes
insipidus, other than decreasing fluid intake. If the condition is related to a
mental illness, treating the mental illness may relieve the diabetes insipidus
symptoms.