Diabetes insipidus is a rare condition that causes an imbalance of fluids in the body, which makes you feel extremely thirsty and produce large amounts of urine. In this article, we will discuss diabetes insipidus in children.
What Causes Diabetes Insipidus In Children
The kidneys help in balancing the body's fluid levels by removing excess fluid from the body and storing it in the bladder as urine. The body regulates fluid levels by producing less urine when you need to replace the lost fluid by sweating or by making more urine when there is excess fluid in the body.
The hypothalamus is a part of the brain that controls the feeling of thirst and signals the body when it needs water. It makes the antidiuretic hormone (ADH), a hormone that helps control how fast or slow the fluids are excreted.
ADH is stored in the posterior pituitary gland. When the body needs to preserve water, the pituitary gland will release the hormone into the bloodstream and when the body needs to get rid of excess water, the hormone is released in smaller amounts and you will urinate more often.
When there is an ADH deficiency or the kidneys do not respond to ADH, diabetes insipidus occur. In either case, the kidneys are unable to concentrate the urine, large amounts of urine are released which leads to diabetes insipidus.
Diabetes insipidus can be caused by other conditions that include the following:
- Brain injury
- Brain tumour
- A hypothalamus gland that doesn't make enough ADH
- Damage to the pituitary gland or hypothalamus during surgery
- Blockage in the arteries leading to the brain
- Tumour near or in the pituitary gland
Types Of Diabetes Insipidus In Children
- Central diabetes insipidus - Enough ADH isn't produced or secreted, which is most often caused by damage to the hypothalamus or pituitary gland.
- Nephrogenic diabetes insipidus - When the kidneys don't respond normally to ADH due to interaction with certain medications such as lithium or chronic disorders like kidney disease or hypercalcemia.
- Dipsogenic diabetes insipidus - This type occurs when there is a problem with the child's sense of thirst.
Symptoms Of Diabetes Insipidus In Children
- Feeling more thirsty than normal
- Weight loss
- Urinating more than normal
Babies with diabetes insipidus will show symptoms like high fever, irritability, poor appetite and failure to grow.
Who Is At Risk For Diabetes Insipidus?
A child is at a higher risk for this condition if he or she has a head injury, brain tumour, brain surgery, or kidney disease.
Complications Of Diabetes Insipidus In Children
- Brain damage
- Poor growth
- Impaired mental function
- Short attention span
Diagnosis Of Diabetes Insipidus In Children
The doctor will ask about the child's health history, family's health history and the signs and symptoms. Based on that, a physical examination will be conducted which include tests like the following.
- Urine test - The child will not drink any fluids for several hours and he or she will then urinate twice within 1 hour. The second urine sample can often diagnose the condition.
- Blood test - A Blood test is conducted to measure salt levels in the blood.
- MRI - This test is done to check for problems in the pituitary gland.
- Water deprivation test - This test is done to check if dehydration occurs when a child doesn't eat or drink.
Treatment Of Diabetes Insipidus In Children
The treatment of this condition depends on the cause. Usually, the treatment is done by providing antidiuretic medications, such as desmopressin which can be taken in the form of pill, injection or nasal spray.
To increase the production of ADH, non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen and water pills are recommended. If the child has nephrogenic diabetes insipidus, the treatment options are anti-inflammatory medications and diuretics (water pills).
Also, modifying the liquids that a child is receiving will help in the treatment of diabetes insipidus.
Diabetes insipidus can be temporary or permanent depending on the cause of the disease. Managing the condition can help the child lead a normal and healthy life. Children with nephrogenic diabetes insipidus can also lead healthy lives only if proper medical care is started at an early stage.