Causes of Diabetes Insipidus – Why Diabetes Insipidus Begins

The causes of diabetes insipidus are very different than the causes of diabetes mellitus and even though they share two common symptoms, which are increased thirst and increased urination, they are two entirely unique diseases.

Causes of diabetes insipidus are most commonly related to a deficiency of antidiuretic hormone (ADH), also known as arginine vasopressin (AVP) or vasopressin. Diabetes mellitus is a condition related to high blood sugar levels caused by too little production of insulin or a failure of the body cells to respond properly to insulin.

To better understand the causes of diabetes insipidus, it helps to understand more about how urine output and thirst are influenced. Urine production is regulated by the hypothalamus, which produces ADH. This hormone is then transported to the pituitary gland where it is stored until needed. The hypothalamus also regulates thirst.

Your kidneys balance fluids in your body and are influenced by ADH. For instance, if ADH is inhibited or deficient your kidneys will release more urine.

There are 4 types of diabetes insipidus and the causes of diabetes insipidus are different for each type.

  1. The most common type is neurogenic diabetes insipidus. This type is also referred to as central diabetes insipidus and results due to a lack of ADH (a.k.a vasopressin).
  2. "Vasopressin acts to increases the volume of blood (intravascularly) and, decreases the volume of urine produced therefore a lack of it causes increased urine production and dehydration"(1).

    Approximately 25 percent of neurogenic diabetes insipidus cases are due to unknown causes. It may be caused by damage to the pituitary gland as a result of a tumor, trauma, neurosurgery or other rare causes. In rare cases this type is due to an inherited mutation of a gene.

  3. The second most common type, nephrogenic diabetes insipidus, is caused by a disorder of the kidney. In this type, the kidneys do not respond properly to ADH and do not concentrate the urine by reabsorbing water. The causes of diabetes insipidus are sometimes acquired meaning they are not present at birth, and this is typically the case with nephrogenic diabetes insipidus. The condition can be due to a kidney or systemic disorder that develops. This form of diabetes insipidus can also be inherited.
  4. Dipsogenic diabetes insipidus is caused by a defect involving the thirst mechanism, which is found in the hypothalamus. The defect leads to an abnormal increase in thirst that reduces ADH secretion and increases urination.
  5. Gestational diabetes insipidus is only present during pregnancy. The placenta normally produces a substance that breaks down ADH but in this disorder the breakdown is extreme.

(1) Wikipedia (2010). Neurogenic diabetes insipidus. Retrieved from http://en.wikipedia.org/wiki/Neurogenic_diabetes_insipidus

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