Diabetes Insipidus
Diabetes insipidus (DI) is a disorder of water balance caused by either a deficiency of antidiuretic hormone (ADH) — central DI — or resistance to ADH in the kidneys — nephrogenic DI. Despite the name, it is unrelated to diabetes mellitus. The cardinal features are polyuria and polydipsia that persist even during water restriction.
When to Book
Book a visit if symptoms are new, persistent, getting worse, or affecting daily life. Early evaluation often prevents complications.
Symptoms
Markedly increased urination (3–20 liters per day), intense thirst and craving for cold water, nocturia disrupting sleep, and dehydration if access to water is restricted. Neonates and young children may present with irritability, failure to thrive, and fever.
Causes & Risk Factors
Central DI is caused by damage to the hypothalamus or posterior pituitary — most commonly by surgery, trauma, tumor, or infiltrative disease (sarcoidosis, histiocytosis). Nephrogenic DI is caused by chronic lithium use, hypercalcemia, hypokalemia, certain medications, or inherited mutations in the ADH receptor. Gestational DI occurs transiently in late pregnancy due to placental vasopressinase.
How We Evaluate
Urine osmolality and sodium distinguish DI from primary polydipsia. The water deprivation test with subsequent DDAVP administration differentiates central from nephrogenic DI. Pituitary MRI with gadolinium evaluates structural causes of central DI.
Treatment Options
Central DI is treated with desmopressin (DDAVP), a synthetic ADH analogue available as nasal spray, oral tablet, or injection. Nephrogenic DI is managed by eliminating the offending cause (e.g., lithium) and using thiazide diuretics plus low-sodium diet. Fluid intake is adjusted to match output.
When It Is Urgent
Severe hypernatremia — sodium above 155 mEq/L — from inadequate water replacement is a neurological emergency. Seek emergency care for confusion, seizures, or loss of consciousness in a patient with DI.
Frequently Asked Questions
Do I need a referral to see an endocrinology provider?
No referral is needed at Nomi Beach Health. You can book directly with our team for hormone, thyroid, metabolic, or weight-management concerns.
How long does it take to see results from treatment?
Timeline depends on the condition. Thyroid medication often improves symptoms within four to eight weeks. Weight-loss interventions show measurable changes in four to twelve weeks. Hormone therapy timelines vary by the specific condition and individual response.
Will I need labs before my first visit?
You can come in without prior labs — we order whatever is appropriate during or after your visit. If you have recent results, bring them so we can start the conversation right away.
Are these conditions managed long-term or treated once?
Most endocrine and metabolic conditions require ongoing management rather than a single treatment. We build a follow-up schedule around your specific diagnosis and goals.
Can I be seen for weight loss even if I do not have a hormone diagnosis?
Yes. We evaluate weight holistically — including metabolic markers, lifestyle factors, and, when appropriate, medication options such as GLP-1 agonists.
Get a Clear Plan for Diabetes Insipidus
Our endocrinology team evaluates you as an individual and builds a treatment plan that fits your life — not a template.