Diabetes insipidus is a rare condition that causes persistent thirst and frequent urination. Cranial diabetes insipidus develops due to difficulties with your hypothalamus or pituitary gland.
Cranial diabetes insipidus, also called central diabetes insipidus, is the
A part of your brain called the hypothalamus produces the hormone vasopressin, which is also called antidiuretic hormone. It’s stored and released in a small gland at the base of your brain called the pituitary gland.
One of the primary functions of vasopressin is to tell your kidneys to retain fluid. People with cranial diabetes insipidus don’t produce enough vasopressin, which leads to them excreting too much water.
In this article, we examine the potential causes of cranial diabetes and how it’s different from other types of diabetes insipidus.
Also known as central diabetes insipidus, this is the most common subtype of diabetes insipidus. It’s caused by problems with the production and secretion of vasopressin, a key hormone in maintaining your body’s fluid balance.
Vasopressin binds to receptors in your kidneys that tell them to retain water. Higher vasopressin levels lead to more water retention, whereas lower levels lead to less.
People with cranial diabetes insipidus don’t release enough vasopressin This might be due to problems with the production of vasopressin by the hypothalamus or problems with the secretion of vasopressin by the posterior pituitary gland.
What’s the difference between cranial diabetes insipidus and diabetes mellitus?
Cranial diabetes insipidus isn’t related to a similar-sounding condition called diabetes mellitus, or simply diabetes.
All subtypes of diabetes insipidus cause excessive thirst and urination.
Central diabetes insipidus is characterized by insufficient vasopressin release from your pituitary gland.
- Nephrogenic diabetes insipidus: Nephrogenic diabetes insipidus is caused by a resistance of your kidneys to the hormone vasopressin. The most common underlying causes are:
- Pregnancy-induced diabetes insipidus: Diabetes insipidus is a rare complication of pregnancy. It affects about 2–4 people per 100,000 pregnancies. It usually occurs at the end of the second trimester or third trimester and resolves within 4–6 weeks of birth.
- Primary polydipsia: Primary polydipsia is when excess fluid consumption causes frequent urination. It might be caused by:
- psychiatric disorders
- certain drugs such as anticholinergics
- tumors or brain infections
- difficulties with your hypothalamus
Cranial diabetes insipidus can develop by itself or together with a
The most common causes of cranial diabetes insipidus are:
Rarer causes include:
- cancer spreading from other body parts
- a rare genetic disorder called Wolfram syndrome
- brain damage from a lack of oxygen, such as during a stroke or while drowning
- brain infections
According to the National Health Service, there’s no known cause in about a third of cases of diabetes insipidus. When this happens, it’s called idiopathic diabetes insipidus. It’s been suggested that an
Doctors often start the diagnostic process by performing a physical exam and reviewing your personal and family history.
- Urinalysis: Urinalysis can show if your urine is diluted. It can also show if your blood sugar levels are too high, which can help rule out diabetes mellitus.
- Blood tests: Blood tests can measure sodium levels and can sometimes help doctors understand which type of diabetes insipidus you have.
- Water deprivation test: A water deprivation test involves avoiding drinking liquids for several hours. A doctor will measure the amount of urine you pass and track changes to your blood and urine.
- Stimulation tests: During this test, you’re given a solution through an intravenous (IV) line that stimulates the production of vasopressin. You’ll then have levels of copeptin measured in your blood. This substance increases with increasing vasopressin levels.
- MRI: MRI can help doctors see damage in your hypothalamus or pituitary gland that might cause diabetes insipidus.
The main symptoms of diabetes insipidus include:
- needing to urinate frequently
- passing large amounts of light-colored urine
- feeling very thirsty
craving cold water
If your diabetes insipidus is mild, the only treatment that may be necessary is drinking more water.
The most common treatment for cranial diabetes insipidus is a synthetic version of vasopressin called desmopressin. It can be taken:
- as a nasal spray
- as a tablet or other oral forms
- through an IV
The underlying cause of your symptoms may also need treatment. For example, one type of tumor linked to diabetes insipidus is called craniopharyngioma. Craniopharyngioma may need to be treated with:
Cranial diabetes insipidus is the most common type of diabetes insipidus. It develops due to changes with your pituitary gland or hypothalamus that leads to an underproduction of the hormone vasopressin.
Cranial diabetes insipidus is commonly treated with a synthetic form of vasopressin called desmopressin. The outlook for most people with diabetes insipidus is excellent if the underlying cause can be treated.