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December 4, 2000

Diabetes Insipidus

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Question from Torrance, California, USA:

My 21 month old son was diagnosed with Diabetes Insipidus several months ago. His sodium level at that time was 195 (which had never been seen that high at the Childrens’ Hospital he had been evaluated at). He was functioning with his level that high. He also was diagnosed with adipsia and had to have a G-tube placed. My question is, is there such a machine that is available to the public to test sodium levels at home ? I average about 4 visits a week to the hospital to get his sodium tested. His sodium can go up or down 10 points very quickly.

Answer:

From: DTeam Staff

There is no home test for sodium available. It does sound as though your child has a condition called congenital adipsia, which may be associated with DI [Diabetes Insipidus]. Does he take a medication called DDAVP, or vasopressin? It is important in children with adipsia that they are given regular amounts of fluid to drink or via the G-tube. These children have lost the control of fluid intake and have no sensation of thirst. If he does have DI as well, it is important that he is on the correct dose of DDAVP or equivalent to ensure that he is not losing too much fluid in urine. It is worth checking this out with your doctor. If you are not clear about anything, make sure you ask.

JS
Additional comments from David Mendosa, A Writer on the Web:

“The Diabetes Insipidus Foundation Inc.” in Baltimore, Maryland, is about the four different types of diabetes insipidus — a different type of diabetes. The four types are Neurogenic, also known as central, hypothalamic, pituitary or neurohypophyseal is caused by a deficiency of the antidiuretic hormone vasopressin; Nephrogenic, also known as vasopressin-resistant is caused by insensitivity of the kidneys to the effect of the antidiuretic hormone vasopressin; Gestagenic, also known as gestational is also caused by a deficiency of the antidiuretic hormone vasopressin that occurs only during pregnancy; and Dipsogenic, a form of primary polydipsia is caused by abnormal thirst and the excessive intake of water or other liquids. The organization’s e-mail address is [email protected] and its phone is (410) 247-3953. The URL is http://diabetesinsipidus.maxinter.net.

“The Nephrogenic Diabetes Insipidus Foundation” is about a disease that is different from diabetes mellitus, but is often confused with it. That’s why it’s listed here. Nephrogenic diabetes insipidus is a condition in which the urine is not concentrated. This is caused by the kidneys’ failure to respond to antidiuretic hormone (ADH). Produced by the pituitary gland, ADH is the messenger which tells the kidneys to keep a certain amount of water in the body before eliminating the remainder as urine. In an NDI patient, the kidneys do not react to the request to process some water for the body’s needs and, instead, constantly route most water out as urine. The URL is http://www.ndif.org/.

DM
Additional comments from Dr. Donough O’Brien:

I am sorry to say that I know of no way in which serum sodium could be measured at home other than by flame photometry or potentiometry and the proper maintenance of such an instrument, even for a trained technician, would be almost as much trouble as going to the hospital.

DOB
Additional comments from Dr. Tessa Lebinger:

Have you tried correlating daily changes in weight with changes in serum sodium? With a very accurate medical scale, you might be able to manage his water balance this way (changes in sodium are really due to changes in water balance in the body).

TGL