Cranial diabetes insipidus

The underlying cause of cranial diabetes insipidus may need treating first. For example, if you are found to have a tumour affecting your hypothalamus or pituitary gland. Your doctor will be able to advise any treatment that you may need.

Otherwise, the following may be suggested:

Careful control of the fluids that you drink. In mild cases, cranial diabetes insipidus may be controlled by ensuring that you are drinking enough fluid to quench your thirst and to keep the salt levels in your blood stable. You may not need any other treatment. Regular monitoring of the salt levels in your blood using blood tests will usually be suggested.

Desmopressin. This is a medicine that resembles ADH. It can have the same effect as ADH on your kidneys. Desmopressin is also known as DDAVP®. It is usually given as nasal drops or nasal spray, or it can be taken as tablets by mouth. You usually need to take desmopressin between one and three times a day. The correct dose for you will be decided by your doctor. The aim is that the medicine should replace the ADH that your body is lacking and so will help to control the amount of urine that you pass.

Sometimes cranial diabetes insipidus may only last for a short period (perhaps a few weeks) after a head injury or brain surgery and so treatment may only be needed in the short term. However, other causes may mean that you need lifelong treatment for diabetes insipidus.

Nephrogenic diabetes insipidus

As mentioned above, sometimes nephrogenic diabetes insipidus can be caused as a side-effect of certain medicines such as lithium. If you are taking such a medicine and you develop diabetes insipidus, your doctor may recommend that the medicine be changed. However, only make changes to your medication on the advice of your doctor.

Nephrogenic diabetes insipidus is not caused by a lack of ADH and so giving desmopressin will not treat the condition. If you have mild nephrogenic diabetes insipidus, your doctor may suggest that you drink plenty of fluids to avoid dehydration. They may also suggest some changes to your diet to help reduce the amount of urine that you produce. For example, eating fewer salty and processed foods and fewer foods that contain protein (such as meat, fish and eggs). You may be referred to a dietician for specialist advice about your diet. You should not make changes to your diet without the advice of an expert.

If you have more severe nephrogenic diabetes insipidus, medication may be suggested. For example, a medicine called hydrochlorothiazide. This medicine can help to reduce the amount of urine that your kidneys produce.

Some other considerations and advice

If you have diabetes insipidus and you develop diarrhoea and/or vomiting, you need to pay particular attention to make sure that you drink plenty of fluids to help prevent lack of water in your body (dehydration). If you have any vomiting and/or serious diarrhoea, you should see a doctor. You also need to take care in hot weather because you will sweat more and so may become dehydrated more easily.

But it is also important that you don't become overloaded with water. This can happen if you are drinking more fluids than you are passing out in your urine or if you are taking too much desmopressin. Water overload can lead to problems with the levels of salts in your blood, particularly sodium. It can make your sodium levels drop too low. Signs that you may be water-overloaded can include headaches, weight gain and dizziness. Low sodium levels can make you feel drowsy and confused and in severe cases can lead to a fit (seizure) and unconsciousness. You should see your doctor if you are concerned about any of these symptoms. To avoid this, never take more desmopressin than you need and, if you are taking desmopressin, follow the advice of your doctor about how much fluid you should drink. Also, your doctor will usually recommend regular blood tests to check on your sodium and other salt levels if you have diabetes insipidus.