Treating diabetes insipidus

Treatments for diabetes insipidus aim to reduce the amount of urineyour body produces.

Depending on the type of diabetes insipidus you have, there are several ways of treating your condition and controlling your symptoms.

Cranial diabetes insipidus

Mild cranial diabetes insipidus may not require any medical treatment.

Cranial diabetes insipidus is considered mild if you produce approximately 3-4litres of urine over 24 hours.

If this is the case, you may be able to ease your symptoms by increasing the amount of water you drink, to avoid Dehydration . Your GP or endocrinologist (specialist in hormone conditions) may advise you to drink a certain amount of water every day, usually at least 2.5 litres.

However, if you have more severe cranial diabetes insipidus, drinking water may not be enough to controlyour symptoms. As your condition is due to a shortage of vasopressin (AVP), your GP or endocrinologist may prescribe a treatment that takes the place of AVP, known as desmopressin (see below).

Desmopressin

Desmopressinis a manufactured version of AVP that's more powerful and more resistant to being broken downthan the AVP naturally produced by your body. It works just like natural AVP, stopping your kidneys producing urine when the level of water in your body is low.

Desmopressincan betaken as a nasal spray, in tablet form or as a form that melts in your mouth, between your gum and your lip. If you're prescribeddesmopressin as anasal spray, you'll need to spray it inside your nose once or twice a day, where it's quickly absorbed into your bloodstream.

If you're prescribeddesmopressin tablets, you may need to take them more than twice a day. This is because desmopressin is absorbed into your blood less effectively through your stomach than through your nasal passages, so you need to take more to have the same effect.

Your GP or endocrinologist may suggest switching your treatment to tablets if you develop a cold that prevents you from using the nasal spray.

Desmopressin is very safe to use and has few side effects. However, possible side effects can include:

• headache
• stomach pain
• feeling sick
• blocked or runny nose
• nosebleeds

If you take too much desmopressin or drink too much fluid while taking it, it can cause your body to retain too much water. This can result in:

• headaches
• dizziness
• feeling bloated
• hyponatraemia a low level of sodium (salt) in your blood

Symptoms of hyponatraemia include:

• a severe or prolonged headache
• confusion
• nausea and vomiting

If you think you may have hyponatraemia, stop taking desmopressin immediately and call your GP for advice. If this isn't possible, go to your local accident and emergency (A&E) department .

Nephrogenic diabetes insipidus

If you have nephrogenic diabetes insipidus that's caused by taking a particular medication, such as lithium or tetracycline, your GP or endocrinologist may stop your treatment and suggest an alternative medication. However, don't stop taking itunless you've been advised to by a healthcare professional.

As nephrogenic diabetes insipidus is caused by your kidneys not responding to AVP, rather than a shortage of AVP, it usually can't be treated with desmopressin. However, it's still important to drink plenty of water to avoid dehydration.

If your condition is mild, your GP or endocrinologist may suggest reducing the amount of salt and protein in your diet, which will help your kidneys produce less urine. This may mean eating less salt and protein-rich food, such as processed foods, meat, eggs and nuts. Don't alter your diet without first seeking medical advice. Your GP or endocrinologist will be able toadvise you about which foods to cut down on.

Side effects are uncommonbut include:

• dizziness when standing
• indigestion
• very sensitive skin
• erectile dysfunction (impotence)in men

This last side effect is usually temporary and should resolve itselfif you stop taking the medication.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) , such as ibuprofen , help reduce urine volume furtherwhen they're used in combination with thiazide diuretics.

However, long-term use of NSAIDs increases your risk of developing a stomach ulcer . To counter this increased risk, an additional medication called a proton pump inhibitor (PPI) may be prescribed. PPIs help protect your stomach lining against the harmful effects of NSAIDs, reducing the risk ofulcers forming.

Diuretics

Diuretic medicine increases the production and flow of urine from the body, used to remove excess fluid from the body.