Diabetes Insipidus

What is diabetes insipidus?

Diabetes insipidus is a rare disorder that occurs when the kidneys release a large amount of fluid through the urine. Children with diabetes insipidus can pass between 3 and 20 quarts of urine in one day. By comparison, a healthy child typically passes 1 to 2 quarts of fluid a day.

Approximately 1 in 30,000 children has diabetes insipidus. These children either don’t have enough of the hormone, vasopressin or their kidneys do not respond to it. As a result, too much water is released into their urine. Insipid means that the urine is diluted and has no odor.

Although the names are similar, diabetes insipidus is different from diabetes mellitus, which includes type 1 diabetes and type 2 diabetes. Both types of diabetes cause frequent urination and thirst but children with type 1 or type 2 diabetes have high blood sugar. Children with diabetes insipidus have normal blood sugar levels.

Prompt diagnosis and treatment of diabetes insipidus in children is very important. If left untreated, the condition can lead to severe dehydration, which can cause brain damage or impaired mental function.

What are the symptoms of diabetes insipidus?

Each child may exhibit slightly different symptoms, but some of the most common symptoms of diabetes insipidus include:

  • excessive thirst
  • excessive urine production during the day and at night
  • dehydration

Infants with diabetes insipidus may also have the following symptoms:

  • irritability
  • poor feeding
  • stalled growth
  • high fever

Types of diabetes insipidus

There are two basic types of diabetes insipidus: central diabetes insipidus and nephrogenic diabetes insipidus.

Central diabetes insipidus occurs when the body doesn’t produce enough vasopressin. About 98 percent of children with diabetes insipidus have this type of the condition. It’s usually caused by a problem with the brain or central nervous system and can be easily treated with medication.

Nephrogenic diabetes insipidus occurs when the kidneys cannot respond to vasopressin. This type is rare and much more difficult to treat.

What causes diabetes insipidus?

Approximately 30 to 50 percent of cases of diabetes insipidus are idiopathic, meaning they have no known cause.

Both central and nephrogenic diabetes insipidus can be caused by several conditions, including:

  • tumor
  • damage to the hypothalamus or pituitary gland during surgery
  • too little vasopressin produced by hypothalmus
  • failure of the pituitary gland to release vasopressin into the bloodstream
  • brain injury
  • family heredity

How we care for diabetes insipidus

The General Endocrinology Program at Boston Children’s Hospital is a multidisciplinary program that provides comprehensive diagnosis, treatment and management of children with diabetes insipidus and other disorders associated with the endocrine system.

As one of the largest pediatric endocrinology programs in the world, we have 35 doctors who see more than 7,000 patients every year. We see many children with temporary or permanent diabetes insipidus brought on by surgery and know how to help patients and their families manage the condition and live healthy lives.