Central Diabetes Insipidus – The Most Common Type of DI

Central diabetes insipidus is the most common type of diabetes insipidus. It is also referred to as neurogenic diabetes insipidus and is characterized by decreased secretions of antidiuretic hormone (ADH) also known as arginine vasopressin (AVP), that results in extreme thirst and excessive urination.

Causes of central diabetes insipidus

Normally the hormone ADH is produced in the hypothalamus gland of the brain and then transported to the pituitary gland for storage. The job of ADH is to limit the amount of urine the body excretes.

In central DI, ADH is not produced in sufficient amounts. This may be due to damage to the hypothalamus or pituitary gland due to a tumor, trauma, neurosurgery or other rare causes. In approximately 25 percent of central DI cases the cause remains unknown. In rare cases this type is due to an inherited mutation of a gene.

Symptoms of central diabetes insipidus

The symptoms of central DI are distinct and include:

  • Increased or excessive urination that may result in accidental bedwetting or frequent trips to the bathroom during the night
  • Increased or excessive thirst and fluid intake

Testing and treatment of central diabetes insipidus

If the symptoms of central DI are noticed you should consult with your doctor immediately. If the disease is suspected, your doctor will perform tests.

  • A urinalysis will show a dilute urine with a low concentration of salt in the urine.
  • A water restriction test will show how well the kidneys are working and how much urine is being produced.
  • A CT or MRI of the head may show a problem involving the pituitary gland.

Treatment should be aimed at correcting the underlying condition. Central DI symptoms can often be positively influenced by the use of a synthetic hormone, desmopressin, which replaces the lack of natural ADH. This drug can be delivered as a nasal spray, oral medication or injection under the skin.

"In mild cases, drinking more water may be all that is needed. If the thirst mechanism is not working (for example, if the hypothalamus is damaged), a prescription for a certain amount of water intake may also be needed (usually 2 - 2.5 liters per day) to ensure proper hydration"(1).

The prognosis for a patient with central diabetes insipidus will depend on the nature of the underlying condition. If the condition can be treated successfully, serious health complications can be avoided.

(1) MedlinePlus (2010). Diabetes insipidus-central. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000460.htm

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