What is partial diabetes insipidus
From Holoprosencephaly
What is partial diabetes insipidus? Are there guidelines that determine this diagnosis?
When I use the term Partial Diabetes Insipidus, I refer to somebody that still makes vasopressin internally and can release it, but may not be releasing enough given their sodium level is elevated. Somebody with complete Diabetes Insipidus makes no hormone at all, so we have to completely replace it.
Most kids with that have Diabetes Insipidus as a result of having Holoprosencephaly make some vasopressin but sometimes not enough, so they become hypernatremic (elevated sodium levels).
Diabetes Insipidus is diagnosed by testing sodium levels and the response, as well as looking at urine concentration. Treatment is then based on the results of the blood tests, as the level of DDAVP is adjusted.
My opinion is that we tend to overdo the lab work. Recently I saw a child that flew in from a different country. He only gets tested once every 6 months to check sodium levels. The child gets a steady dose of DDAVP twice a day. They give him enough DDAVP to keep him from getting dehydrated. Then, they control the fluid intake.
The mother changes the fluid intake based on symptoms displayed by the child. She tests hydration by looking at his eyes and mouth, heart rate, skin moisture, and urine output. If dry, she gives more water, if wet, she gives less fluids.
Often times, parents want to trust their instincts but they’re talked out of it by people treating their child, thinking they can do better job by taking labs. I think DI can be managed effectively with fewer lab tests.
See also: Central Diabetes Insipidus
