Pediatric Diabetes Insipidus

Young girl is getting her blood tested by a doctor

Diabetes insipidus is a relatively rare disease that causes the kidneys to emit a larger than usual amount of urine. This urine is called "insipid", a term that means "colorless and diluted". There are four main sub-categories of diabetes insidious, and none is related to the better-known forms of diabetes (1 and 2). Diabetes insipidus can be especially dangerous for young patients.

In this post, learn more about how diabetes insipidus, commonly called "water diabetes", is diagnosed and treated in children through the medical practice of pediatric endocrinology.

Kidney Function in Diabetes Insipidus

The kidneys are two fist-sized organs located on either side of the body nearer the back waist area. These organs are responsible for filtering the blood to rid it of toxins. When the toxins have been filtered, the kidneys produce liquid called urine that carries the toxins out to be excreted.

The kidneys rely on an antidiuretic hormone called vasopressin to help them regulate how much water to produce to carry the filtered toxins out of the body.

In individuals suffering from diabetes insipidus, the hypothalamus gland produces inadequate amounts of vasopressin. This causes the kidneys to secrete too much water, which can result in dehydration and other serious complications.

Four Sub-Types of Diabetes Insipidus

There are four main recognized sub-categories of water diabetes. Each category is described as follows:


Gestational water diabetes occurs when a placental enzyme interrupts a woman's vasopressin production. Gestational diabetes insipidus are usually mild and tend to retreat on their own once the woman has given birth.


Central diabetes insipidus arises when the hypothalamus or pituitary gland sustains damage, which interrupts production of vasopressin. Damage can be hereditary or caused by illness or surgery. Not all cases of central diabetes insidious can be traced back to a known trigger.


Some of the causes of Nephrogenic diabetes insipidus are known and others are not yet known. Some causes include inherited gene mutations, while others may relate to an imbalance in calcium or potassium. Blockage of the urinary tract or chronic kidney disease is other potential triggers, as is taking certain medications (lithium is one example).


In Dipsogenic water diabetes, a hypothalamus defect is a cause. This defect relates directly to a perception of thirst. When the thirst perception is disrupted, the individual will drink more and produce more urine. There are many possible causes for this defect, including surgery, illness, a tumor growth, infection, and injury. It is thought that certain medicines may trigger the onset of this type of water diabetes.

Diabetes Insipidus in Young Patients

Complications arising from water diabetes can be particularly dangerous when the patient is young. Part of the reason for this is that children may not verbalize how they are feeling soon enough or at all. Since excessive thirst, a primary symptom of diabetes insipidus can masquerade as many other ailments, it can be hard to catch it quickly in children.

As well, because children's bodies and brains are still growing rapidly, damage from undetected diabetes insipidus can be more severe. Untreated water diabetes can cause all of the following:

  • Brain damage
  • Hyperactivity
  • Restlessness
  • Short attention span
  • Impaired cognitive or mental function
  • Seizures
  • Death

Symptoms of Diabetes Insipidus

Since the symptoms of diabetes insipidus can mimic other illnesses, it is critical to know the warning signs. The most common symptoms of the onset of diabetes insipidus include these:

  • Excessive thirst
  • Confusion
  • Dizziness
  • Sluggishness
  • Nausea
  • Dry skin
  • Fatigue
  • Excessive urine production
  • Failure to grow (in young patients)
  • Failure to feed (in young patients)
  • High fever
  • Irritability

Diagnosing Water Diabetes in Children

There are a number of possible tests that can be performed to obtain an accurate diagnosis of diabetes insipidus. Before specific tests are ordered, the physician will do a physical exam to look for surface signs of dehydration, including dry skin and complaints of thirst.

After the physical exam, the physician may order any or all of these additional tests to confirm the diagnosis:

Fluid Deprivation.

Essentially, this is a test where the fluid is withheld from the individual to see if symptoms of dehydration arise. This should only be done in a hospital setting where the patient can be closely monitored.

MRI (Magnetic Resonance Imaging)

This test looks for changes in the pituitary gland.


This test evaluates the urine for the level of concentration or diluteness and levels of glucose (to determine which form of diabetes may be present).

Blood Test

This test evaluates the level of sodium in the blood to determine the type of diabetes.

Treating Water Diabetes in Children

The type of diabetes and age of the patient does make a difference in which treatment is prescribed for diabetes insipidus. The treatment will always be tailored to the cause if a cause can be determined (in some cases, causes remain unknown to date).

As well, when options exist, the parents will be able to have a say in which course of treatment is pursued.

Common treatments for water diabetes in young patients include these:

  • Increase fluid intake to guard against dehydration
  • Use of a nasal spray, pill, or injection to stimulate vasopressin production
  • Continual monitoring of the blood for changes in sodium levels

The ultimate scenario for young patients is treatment to be started promptly.