Blog
Diabetes insipidus
Covenant Metabolic Specialists Health Library
Covenant Metabolic Specialists
Physician Reviewed
Dec 3, 2025
Diabetes insipidus (DI) is a rare condition where the kidneys are unable to conserve water, leading to excessive urination and constant thirst. It is not related to type 1 or 2 diabetes but can result in serious dehydration if untreated.
What is Diabetes Insipidus?
DI occurs when your body doesn’t produce or properly use antidiuretic hormone (ADH), which helps the kidneys regulate water balance. It leads to the excretion of large amounts of dilute urine and extreme thirst.
Symptoms
Intense thirst (polydipsia)
Excessive urination (polyuria)
Nocturia (frequent nighttime urination)
Fatigue or dehydration
Dry skin
Low blood pressure
Headaches
Causes
Central DI: Pituitary or hypothalamic dysfunction reduces ADH production
Nephrogenic DI: Kidneys don’t respond to ADH
Gestational DI: Placenta breaks down maternal ADH
Primary polydipsia: Excessive water intake overwhelms ADH system
Risk Factors
Head injury, brain surgery, pituitary tumors
Lithium use or chronic kidney conditions
Pregnancy
Family history (rare hereditary cases)
Diagnosis
Water deprivation test
Urine osmolality
Serum sodium and osmolality
MRI to evaluate pituitary function
Treatments
Desmopressin (DDAVP): Synthetic ADH (central DI)
Low-sodium diet and diuretics (nephrogenic DI)
Hydration monitoring
Prevention
There’s no true prevention, but early diagnosis prevents complications from dehydration and electrolyte imbalance.
Our Take
DI often masquerades as anxiety, overhydration, or even diabetes mellitus. But its root is hormonal—and fixable. We help patients restore balance and reclaim comfort.
