No, You Do Not Have Diabetes Insipidus
If your urine output per void is 200 mL or under, you definitively do not have diabetes insipidus (DI). This volume is far too small to be consistent with this diagnosis.
Why This Rules Out Diabetes Insipidus
Characteristic Void Volumes in DI
Patients with DI produce massive individual void volumes that cause bladder dysfunction in 46% of cases, with volumes so large they cause "bed flooding"—a clinical term indicating that single nocturnal voids exceed the capacity of standard containment measures 1
Children with DI require "double nappies" (double-layered diapering) because single void volumes overflow the inner diaper, necessitating an outer adult-sized diaper to absorb the overflow 1
The pathophysiology explains why volumes are so large: patients with DI produce maximally dilute urine continuously (osmolality <200 mOsm/kg H₂O) because their collecting tubules cannot respond to or lack ADH, meaning the kidneys cannot concentrate urine at all 2
Your Volumes Are Normal
A void volume of 200 mL or under is within the normal range for typical bladder function and does not suggest any inability to concentrate urine 3, 2
The diagnosis of DI requires polyuria >3 liters per 24 hours in adults, which translates to much larger individual void volumes than what you're describing 3
What Defines Diabetes Insipidus
Diagnostic Criteria
DI is diagnosed by the combination of:
The kidneys' inability to concentrate urine results in high urine volume with maximally dilute urine produced continuously, regardless of fluid consumption 2
Clinical Presentation
Patients with DI exhibit extreme thirst and craving for cold water, drinking enormous volumes just to compensate for urinary water losses—not because they're drinking excessively, but because their kidneys cannot retain water 2, 5
Adults with unexplained polydipsia and polyuria (>2.5 L per 24 hours despite attempts to reduce fluid intake) should be evaluated for DI 3
Common Pitfall to Avoid
Many conditions can cause urine osmolality in the 200-300 mOsm/kg range without representing true DI, including partial dehydration, chronic kidney disease, or early stages of various renal disorders 3
Do not confuse DI with diabetes mellitus, which causes polyuria through osmotic diuresis from glucosuria (fasting glucose ≥126 mg/dL or random glucose ≥200 mg/dL with symptoms), not from ADH deficiency 3, 6
Bottom Line
Your void volumes of 200 mL or under are inconsistent with DI, which produces massive individual void volumes that overwhelm normal bladder capacity and cause significant urological complications 1. If you have concerns about excessive urination, consider other causes such as diabetes mellitus, excessive fluid intake, or other renal conditions, but DI is not the diagnosis with these void volumes 3, 7.