Diabetes insipidus is a condition characterized by the overproduction of urine. It can lead to a potentially serious condition called hypernatremia when sodium levels in your blood are elevated.

Diabetes insipidus, now called arginine vasopressin disorder, is a condition where your body produces too much urine. The overproduction of urine can cause the loss of too much fluid from your body and dehydration.

Hypernatremia is a potential complication of dehydration. It occurs when sodium levels in your blood are higher than normal. It can range from mild to severe depending on your sodium levels. Severe hypernatremia can lead to coma or even death.

Keep reading to learn more about the connection between diabetes insipidus and hypernatremia.

Hypernatremia is a potential complication of diabetes insipidus. Diabetes insipidus is rare, affecting about 1 in 25,000 people, but it can have many causes including:

  • autoimmune disease
  • brain trauma
  • birth defects
  • cancer

Diabetes insipidus can develop due to insufficient production and release of a hormone called antidiuretic hormone (ADH) or an improper response to this hormone by your kidneys. ADH tells your kidneys to retain fluid. It’s also called vasopressin or arginine vasopressin.

The overproduction of urine can cause your body to lose fluid quicker than you replenish it. When the amount of fluid in your blood decreases, the concentration of electrolytes like sodium increases. Hypernatremia occurs if the concentration of sodium increases above the upper limit in the normal range.

Hypernatremia can also be a complication of other causes of dehydration, such as exercising in hot weather.

Although diabetes insipidus can cause hypernatremia, many people who have it are able to maintain a typical sodium level since they have both polydipsia (increased thirst) with polyuria (increased urine production).

Adipsic diabetes insipidus

A specific type of diabetes insipidus called adipsic diabetes insipidus is characterized by loss of thirst despite rising sodium levels in your blood. Normally, your body increases thirst as a way to dilute sodium and pass it out of your body through urine.

People with adipsic diabetes insipidus are at a high risk of life threatening hypernatremia. Research indicates that fewer than 100 severe cases have been reported in about the past 40 years.

Adipsic diabetes develops due to damage to the anterior part of your hypothalamus. It can be associated with a type of brain tumor called a craniopharyngioma.

Why are researchers trying to change the name of diabetes insipidus?

In 2022, many international groups like the Endocrine Society and the European Society of Endocrinology proposed to change the name of diabetes insipidus to arginine vasopressin disorder.

There are several reasons for the change, but one of the main reasons is to avoid confusion with diabetes mellitus, which is more commonly shortened to diabetes.

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Diabetes insipidus does not cause hyponatremia.

One possible correlation between the two conditions is a complication related to the use of desmopressin and unrestricted fluid intake that can cause hyponatremia, but this is due to the medication, not the disease.

The two conditions may also have common risk factors like spinal cord injury. As many as 80% of people with spinal cord injuries develop hyponatremia. Spinal cord injury might lead to diabetes insipidus by damaging your sympathetic nervous system and decreasing your blood pressure and heart rate.

Hyponatremia is common following pituitary gland surgery, occurring in up to 35% of people. Pituitary gland surgery can also cause diabetes insipidus.

Following pituitary surgery, some people develop a triphasic response characterized by an increase in the release of ADH, which causes the body to retain more water, usually within 5 to 8 days, and another phase of diabetes insipidus, which is often permanent.

Symptoms of hypernatremia include:

Severe cases can cause:

It’s important to visit a doctor if you notice yourself urinating more often than usual.

According to the United Kingdom’s National Health Service (NHS), people with mild diabetes insipidus may produce 3 to 4 liters (L), or 0.79 to 1.06 gallons (gal), of urine per day, while people with severe disease may produce up to 20 L, or 5.28 gal, per day.

A typical amount of urine for adults is roughly 1 milliliter per kilogram (kg) per hour, or roughly 1.8 L (0.48 gal) for a 74.8 kg (165-pound) person.

Diabetes insipidus treatment aims to reduce the amount of urine you produce and address the underlying cause.

Mild cases often don’t need specific treatment and can be managed by increasing water consumption to avoid dehydration. Your doctor may recommend consuming less sodium to help reduce your urine production.

For more severe cases of diabetes insipidus, you may need to take desmopressin. Desmopressin is a synthetic version of ADH.

Diabetes insipidus is a condition characterized by the overproduction of urine. It can lead to dehydration and hypernatremia. Hypernatremia can be mild or life threatening depending on how high your sodium levels are.

It’s important to see a doctor if you suspect you may have diabetes insipidus. If your condition is mild, you might not need any particular treatment, but severe cases often require medication to prevent complications.

It’s also important to see a doctor if you have signs of hypernatremia, especially if they’re severe.