Diabetes Insipidus medications & treatments

Medically reviewed by  Jamie Winn, PharmD

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Diabetes insipidus is a rare condition that affects about 1 in 25,000 people worldwide. It affects men and women equally. Diabetes insipidus can occur at any age, but adults are more likely to develop this condition. Less than 10% of diabetes insipidus cases are caused by an inherited genetic mutation and 33% of cases have no identifiable cause.

What is diabetes insipidus?

Diabetes insipidus (DI) is a rare but treatable condition that causes you to have an almost unquenchable thirst and your body to make too much urine. While most people normally make 1 to 3 quarts of urine per day, people with diabetes insipidus can make up to 20 quarts of urine per day (polyuria). It is typically due to a decreased production of antidiuretic hormone (ADH), also known as vasopressin, or a decreased response to ADH.

Diabetes insipidus causes

The causes can vary among the four types of diabetes insipidus, including:

• Central diabetes insipidus. Central DI is the most common form of diabetes insipidus. It is usually due to damage to the pituitary gland (a small gland found in the base of the brain)or hypothalamus from surgery, a tumor, rare genetic conditions, or a head injury. The damage disrupts the usual production, storage, and release of ADH.
• Nephrogenic diabetes insipidus. Nephrogenic DI can be an inherited disorder or acquired due to a chronic kidney disorder. It is typically caused by a gene mutation, certain medications (lithium, tetracycline), urinary tract blockage, electrolyte imbalances (calcium, potassium), and chronic kidney disease.
• Gestational diabetes insipidus. Gestational diabetes insipidus is a rare form that only occurs during pregnancy. It usually is due to an enzyme made by the placenta that destroys the mother’s ADH. It can also be a result of increased levels of prostaglandin, which makes your kidneys less sensitive to ADH. This condition typically resolves after giving birth.
• Dipsogenic diabetes insipidus. Also known as primary polydipsia, this form is due to dysfunction of the thirst-regulating mechanism in the hypothalamus. This causes you to drink excessive amounts of fluids, resulting in large amounts of diluted urine. It can be caused by damage to your hypothalamus from surgery, infection, a tumor, or injury.

How is diabetes insipidus diagnosed?

To properly diagnose diabetes insipidus, your doctor or healthcare professional will look at your symptoms, review your medical history, perform a physical exam, and run some tests, including:

• Urinalysis. In this test, you will give a sample of your urine to your doctor to determine if it’s too diluted or concentrated. It can also be used to check your glucose level to see if you have diabetes insipidus or diabetes mellitus.
• Blood test. A blood test can be used to measure sodium levels, as well as other electrolytes and glucose in your blood. This can help diagnose diabetes insipidus as well as the type.
• Water deprivation test. With this test, you will not drink any liquids for several hours. Your healthcare provider will measure the amount of urine your produce. You will continue to produce large amounts of dilute urine if you have diabetes insipidus.
• Magnetic resonance imaging (MRI). An MRI uses a magnetic field and radio waves to produce images of your brain tissues. It can be used to check for abnormalities or damage to your hypothalamus or pituitary gland, which can be the cause of your diabetes insipidus symptoms.

Diabetes insipidus symptoms

Some common symptoms of diabetes insipidus include:

• Extreme thirst or excessive thirst
• Frequent or excessive urination
• Increased urine volume
• Pale or colorless urine
• Night-time urination (nocturia)
• Fatigue

Infants or young children with this condition can have signs and symptoms, such as:

• Heavy, wet diapers
• Irritability
• Fever
• Delayed growth
• Poor feeding
• Weight loss

What are some diabetes insipidus treatment options?

Your treatment plan will depend on which type of diabetes insipidus you have. The treatment goals will be ensuring you are taking in the proper amount of fluids and reducing urine output. This will help prevent complications such as dehydration.

Medications

• DDAVP (desmopressin). Desmopressin is a synthetic version of an antidiuretic hormone (ADH, vasopressin), which controls urine output, maintains your water balance, and prevents dehydration. It is used to treat central DI and gestational DI. Desmopressin is available in a tablet, a nasal spray, or an injection.
• Microzide (hydrochlorothiazide). This medication is a thiazide diuretic used to treat nephrogenic DI. Although hydrochlorothiazide is a diuretic that is used to increase your urine output, it can reduce the amount of urine your kidneys produce.
• Indocin (indomethacin). Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that can help reduce urine volume when used in combination with thiazide diuretics.

What is the best medication for diabetes insipidus?

The best medication for the treatment of diabetes insipidus will depend on the individual’s specific medical condition, medical history, medications that the individual is already taking that may potentially interact with diabetes insipidus medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter diabetes insipidus medications approved by the Food and Drug Administration (FDA).

Best medications for diabetes insipidus

Your healthcare provider will determine the right dosage based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.

What are the most common side effects of diabetes insipidus medications?

As with all medicines, those used for diabetes insipidus will have some side effects, depending on the class you are taking:

• DDAVP (desmopressin) – Dry mouth, runny nose, headache, low sodium levels, dizziness, stomach pain
• Indocin (indomethacin) and other NSAIDs – Headache, dizziness, indigestion, stomach pain, nausea, heartburn, rash
• Diabinese (chlorpropamide) – Increased potassium levels, low sodium levels (hyponatremia), hypoglycemia, constipation, upset stomach
• Microzide (hydrochlorothiazide) – Dizziness, headache, upset stomach, electrolyte imbalance

What are some home remedies for diabetes insipidus?

There is no home remedy or way to naturally cure this condition.  

Diabetes insipidus prevention

If you have diabetes insipidus, it’s important to drink plenty of fluids to make sure you don’t get dehydrated.

Your health care professional may suggest reducing the amount of salt and protein in your diet, which may help your kidneys make less urine if you have nephrogenic DI.

You should also wear a medic alert bracelet or carry a card that explains your condition in case of an emergency.

Frequently asked questions about diabetes insipidus

What is the difference between diabetes insipidus and diabetes mellitus?

Diabetes insipidus and type 1 and type 2 diabetes mellitus both cause increased thirst and frequent urination. People with diabetes mellitus have high blood glucose levels. In diabetes insipidus, your blood glucose levels are normal but your kidneys are unable to concentrate urine.

What are some complications of diabetes insipidus?

Diabetes can cause some serious complications if not treated properly including:

• Severe dehydration. If you have diabetes insipidus, your body cannot hold on to water, which can lead to dehydration. If left untreated, severe dehydration can lead to seizures, brain damage, or death.
• Electrolyte imbalance. Because of frequent urination, diabetes insipidus can cause an imbalance of your electrolyte levels. This can lead to headaches, fatigue, muscle pain, and irritability.

Is diabetes insipidus fatal?

Diabetes insipidus usually doesn’t cause serious problems. If you drink enough water, you will rarely have any serious complications. The risk of death is higher for infants, senior citizens, and those with certain mental illnesses.

What foods or drinks should I avoid with diabetes insipidus?

Your doctor may recommend avoiding salt and reducing the protein in your diet to help reduce your symptoms. High-salt foods include fast foods, salted snacks like peanuts and pretzels, beets, carrots, celery, and spinach. You should also avoid or limit meats, eggs, caffeinated beverages, and alcohol.

Related resources for diabetes insipidus

• Diabetes insipidus symptoms and causes. Mayo Clinic
• Diabetes insipidus health information. National Institute of Diabetes and Digestive and Kidney Diseases
• What is diabetes insipidus? WebMD
• The treatment options for diabetes insipidus, depending on the specific etiology. StatPearls, National Library of Medicine
• Diabetes insipidus practice essentials. MedScape