What is Diabetes Insipidus (DI)?

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Last updated: April 7, 2025View editorial policy

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From the FDA Drug Label

Diabetes Insipidus: Desmopressin acetate injection 4 mcg/mL is indicated as antidiuretic replacement therapy in the management of central (cranial) diabetes insipidus and for the management of the temporary polyuria and polydipsia following head trauma or surgery in the pituitary region. Diabetes insipidus is a condition that can be managed with desmopressin acetate injection, specifically central (cranial) diabetes insipidus.

  • It is characterized by polyuria (excessive urine production) and polydipsia (excessive thirst)
  • Desmopressin acetate injection is used as antidiuretic replacement therapy to manage this condition 1.

From the Research

Diabetes insipidus is a rare disorder that causes an imbalance of fluids in the body, characterized by excessive thirst and urination, and its treatment should prioritize maintaining fluid intake ahead of fluid loss to preserve quality of life, as emphasized in the most recent study 2. Diabetes insipidus occurs when the body cannot properly regulate water balance due to problems with antidiuretic hormone (ADH), also called vasopressin. There are two main types: central diabetes insipidus, caused by insufficient production of ADH by the pituitary gland, and nephrogenic diabetes insipidus, where the kidneys don't respond properly to ADH.

Key Characteristics and Treatment

  • Symptoms include extreme thirst, producing large amounts of dilute urine (3-20 liters daily), and frequent urination including at night.
  • Treatment depends on the type but may include desmopressin (DDAVP) for central diabetes insipidus, administered as a nasal spray, oral tablet, or injection, as discussed in 3 and 4.
  • For nephrogenic diabetes insipidus, thiazide diuretics, NSAIDs, or a low-salt diet may be prescribed, with thiazide diuretics potentially reducing urine flow by increasing proximal tubular reabsorption of sodium, as noted in 5 and 6.

Importance of Proper Management

Without treatment, severe dehydration and electrolyte imbalances can occur, potentially leading to seizures, brain damage, or death in extreme cases. This condition is distinct from diabetes mellitus (type 1 or 2), which involves blood sugar regulation rather than water balance.

Recent Guidance

The most recent study 2 highlights the importance of maintaining fluid intake ahead of fluid loss to preserve quality of life, emphasizing the need for careful management of diabetes insipidus to prevent severe complications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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