Health Conditions A-Z Endocrine Diseases Signs and Symptoms of Diabetes Insipidus By Angela Ryan Lee, MD Angela Ryan Lee, MD Angela Ryan Lee, MD, FACC, is a board-certified cardiology and internal medicine physician. She also holds board certifications from the American Society of Nuclear Cardiology and the National Board of Echocardiography. health's editorial guidelines Published on April 24, 2024 Medically reviewed by Kelly Wood, MD Medically reviewed by Kelly Wood, MD Kelly Wood, MD, is a board-certified endocrinologist with a special interest in osteoporosis and metabolic bone disease. learn more In This Article View All In This Article Common Symptoms Central Diabetes Insipidus Symptoms Nephrogenic Diabetes Insipidus Symptoms Gestational Diabetes Insipidus Symptoms Symptoms in Children When To See a Healthcare Provider FAQs Trending Videos Close this video player Diabetes insipidus is a rare condition that causes you to lose too much water through your urine, interfering with proper fluid balance in your body. You can develop diabetes insipidus if you have a deficiency of or resistance to antidiuretic hormone (ADH), also known as vasopressin, a hormone responsible for keeping water levels balanced in the body. This condition should not be confused with diabetes mellitus, which includes type 1 and 2 diabetes and is related to the resistance or underproduction of insulin. Diabetes insipidus is much less common, affecting approximately 1 in 25,000 people worldwide. Diabetes insipidus can occur when the brain does not make enough ADH or when the kidneys do not respond appropriately to the hormone. Regardless of the cause, symptoms of diabetes insipidus include frequent urination and extreme thirst. Headache and vision problems are also possible if the condition stems from a brain condition. Design by Health / Getty Images Common Symptoms The main symptoms of diabetes insipidus are frequent urination (polyuria) and extreme thirst (polydipsia). Loss of excess water can also cause dehydration. Frequent Urination Frequent urination occurs in diabetes insipidus because of low levels of ADH or, less commonly, from resistance to ADH. ADH is responsible for telling the kidneys to hold on to water to keep the balance of sodium and water in the body. With diabetes insipidus, there is a problem with the signal to hold on to water, leading to an excess loss of water in the urine. People with diabetes insipidus can lose as much as 20 quarts of water per day and may find themselves urinating very frequently, such as every hour. The urine is watered down (diluted) and so may appear pale. You may even find yourself waking up in the middle of the night to urinate, a symptom known as nocturia. Nocturia can interrupt your sleep as often as every hour, resulting in poor-quality sleep. Extreme Thirst If you have diabetes insipidus, you might often feel very thirsty. The water loss you experience through your urine causes blood sodium levels to rise, a condition known as hypernatremia. In response to the increased sodium levels, the brain sends signals for increased thirst so you can replace the lost water and maintain normal sodium levels. People with diabetes insipidus may drink gallons of water a day to quench their thirst. Dehydration When you lose too much fluid, it's possible to become dehydrated. Symptoms of dehydration include: TirednessDizziness or lightheadednessDry skin and mouthHeadacheConfusion In severe cases, dehydration can cause rapid heart rate, loss of consciousness, and low blood pressure (hypotension). Central Diabetes Insipidus Symptoms Most times, it's a problem in the brain that leads to a deficiency of ADH and causes diabetes insipidus. In these cases, the condition is referred to as central diabetes insipidus. With central diabetes insipidus, the hormone-making pituitary gland that sits in the brain cannot properly make or release ADH. This can happen for several reasons, including head trauma or an infection like meningitis. Central diabetes insipidus causes the common symptoms of extreme thirst and frequent urination. However, there may be other symptoms if the cause of the diabetes insipidus is brain-related, including headaches and double vision. Nephrogenic Diabetes Insipidus Symptoms Nephrogenic diabetes insipidus happens when there is enough ADH but the kidneys don't respond appropriately to it or are resistant to it. This type of diabetes insipidus can happen for several reasons, including due to lithium use (a medication for bipolar disorder) or severe electrolyte disturbances (such as high calcium levels in the blood, or hypercalcemia). The symptoms of nephrogenic diabetes insipidus are the same as for diabetes insipidus in general: frequent urination and thirst. However, on top of these common diabetes insipidus symptoms, there may be symptoms related to the underlying cause of the diabetes insipidus. For example, taking too much lithium over time can lead to hand tremors, slurred speech, and muscle twitches. Meanwhile, hypercalcemia may cause nausea, vomiting, muscle weakness, and confusion. Gestational Diabetes Insipidus Symptoms Another form of diabetes insipidus—gestational diabetes insipidus—can happen during pregnancy. This condition is not due to a brain or kidney problem like the other types of diabetes insipidus. Rather, in gestational diabetes insipidus, the placenta makes a hormone called vasopressinase that breaks down ADH. This hormone is most active during the third trimester of pregnancy. Pregnancy itself causes increased urination, particularly in the third trimester as the uterus places pressure on the bladder. However, people who are pregnant and have gestational diabetes insipidus have even more extreme amounts of urination in the third trimester. Symptoms in Children Infants and children with ADH cannot replenish the water they lose in urine as well as adults since younger kids might not be able to communicate their thirst. Because they might not get the fluids they need, infants and children can develop dehydration as well as high sodium levels in the blood. Infants with diabetes insipidus may have the following symptoms: Irritability Lethargy Vomiting Constipation Fever Meanwhile, children with diabetes insipidus may experience: Bedwetting Weight loss Growth problems Fatigue When To See a Healthcare Provider The symptoms of diabetes insipidus are nonspecific, meaning several other conditions can cause the same symptoms. For instance, frequent urination can signal a urinary tract infection or prostate problem. If you have symptoms of diabetes insipidus with no other clear explanation, discuss the symptoms with your healthcare provider. They can order lab and urine tests to evaluate your symptoms and, if needed, offer treatment. Severe symptoms that warrant immediate medical care include signs of severe dehydration, such as: Dizziness or lightheadednessLoss of consciousnessConfusionRapid heart rate Questions To Ask Your Provider If you decide to seek further care, consider asking your healthcare provider the following questions: How can I tell if my extreme thirst and frequent urination is due to diabetes insipidus, diabetes mellitus, or another condition? Could my nighttime urination be related to anything other than diabetes insipidus, such as a prostate problem? Do you recommend any specific amount of fluid intake to deal with thirst during the day? Do you have any tips for dealing with urination at nighttime? Is there any type of drink or food that can best help replenish my lost fluid? A Quick Review Diabetes insipidus is a rare hormone-related condition that causes you to lose too much water in your urine. Because of this, your body's fluid levels can get out of balance. The major symptoms of diabetes insipidus are frequent urination, including waking up at night frequently to urinate, and extreme thirst. These symptoms can lead to dehydration, which can cause confusion and loss of consciousness if not treated. Depending on the exact cause of your diabetes insipidus, you may have other symptoms, too, such as headache and double vision. The symptoms of diabetes insipidus overlap with many other conditions. Talk with your healthcare provider if you have symptoms of diabetes insipidus, as the provider can diagnose the problem with lab tests and start any necessary treatment. Frequently Asked Questions What are the 3 P's of diabetes? The 3 P's of diabetes refer to diabetes mellitus and include polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (hunger). In diabetes insipidus, only 2 of the P's occur: polyuria and polydipsia.Diabetes mellitus and diabetes insipidus share these two symptoms, but they are completely different conditions that affect different parts of the endocrine system (the system in charge of producing and releasing hormones). What happens if diabetes insipidus is left untreated? If left untreated, diabetes insipidus can cause severe complications, especially in someone who doesn't have access to replenish the fluids lost in the urine. Elevated sodium levels in the blood, known as hypernatremia, can cause confusion, seizures, and death. Severe dehydration may also occur, leading to rapid heart rate, low blood pressure, and loss of consciousness. At what age do people develop diabetes insipidus? Diabetes insipidus can happen at any age. In those with certain genetic mutations, diabetes insipidus can be diagnosed at birth. However, other people may not develop the condition until much later in life when there is another cause like lithium use or a brain tumor. Was this page helpful? Thanks for your feedback! Tell us why! Other Submit 8 Sources Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. MedlinePlus. Diabetes insipidus. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes insipidus. National Organization for Rare Disorders. Central diabetes insipidus. MedlinePlus. Dehydration. Bichet DG, Verbalis JG. Arginine vasopressin deficiency (central diabetes insipidus): Etiology, clinical manifestations, and postdiagnostic evaluation. In: Sterns RH, Christ-Crain M, eds. UpToDate. UpToDate; 2023. MedlinePlus. Lithium toxicity. MedlinePlus. Hypercalcemia. Thadhani RI, Maynard SE. Polyuria and diabetes insipidus of pregnancy. In: Glassock RJ, Sterns RH, eds. UpToDate. UpToDate; 2021.