
April 30, 2003
Diabetes Insipidus
Question from Mitchell, South Dakota, USA:
My 22 month old son drinks all the time. I was concerned with all his drinking and urination so I took him into the doctor. She said that usually with diabetes, the person in question is sick with weight loss and some other things, but they checked his urine just to be safe which was negative for sugar. However, she said that he was lacking something (I don’t remember what) and that his urine wasn’t concentrating. I could have sworn that she said “diabetes”? Something followed, but I can’t recall. I have been reading, and I can only find two types of diabetes. Was I imagining it? Is there such a thing?
Answer:
I think that the term you are looking for is Diabetes Insipidus which has nothing at all to do with the very much more common type 1A (autoimmune) diabetes as it is now usually known. Glucose metabolism is quite normal in Diabetes Insipidus, and there are broadly three kinds.
One is psychogenic in which an infant or small child begins to drink compulsively which results in a corresponding increase in urine volume and a decrease in urine solute concentration depending on what they drink. The other two types are ‘nephrogenic’ which is inherited in an X linked or autosomal form and in which the kidney tubules have lost some of their ability to reabsorb water. These children do not respond to the pituitary hormone vasopressin, but may be helped by less specific drugs like hydrochlorthiazide and indomethacin. Finally, ‘central diabetes insipidus’ is due to a defect in vasopressin synthesis in the hypothalamus and treatment is with desmopressin (DDAVP) a synthetic form of vasopressin.
I hope this helps, and I apologise if it seems a bit technical; but it is intended to give you some information to explore with the doctor. There are well defined tests for diagnosing this disorder and for distinguishing the several types.
DOB