Diabetes Insipidus: When Frequent Urination Becomes Life-Threatening

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Everyone knows the frustration of having to leave a cozy bed to make a nighttime bathroom run. Imagine if you had to use the bathroom, and then rehydrate, so often that you could never sleep for more than 2 hours at a time. That’s exactly what German man Marc Wübbenhorst has to deal with every day in order to stay alive. Marc has diabetes, but a form most of us haven’t heard about: diabetes insipidus.

Diabetes insipidus causes the body to urinate too frequently, putting someone at risk of dehydration in a matter of hours instead of days. This over-production of urine is caused either by the body not providing enough of the anti-diruetic hormone vasopressin, or by the kidneys not properly responding to the hormone. In either case, the kidneys don’t properly manage urine production, and too much water is eliminated. Someone with diabetes insipidus, depending on the type and severity, will produce between 3 and 30 liters (up to almost 8 gallons) of urine each day.

Marc needs to use the bathroom up to 50 times in a day. Since his kidneys are constantly producing diluted urine, he has to constantly be replacing lost fluids. Marc must drink about 10 liters of water a day, or just over 2.5 gallons. If Marc were to go without rehydrating for only two hours he would experience the symptoms of severe dehydration: dizziness, cracked lips, and confusion. In a matter of hours his dehydration would be life-threatening.

The term diabetes insipidus refers to the passing of large amounts of bland or diluted urine, whereas diabetes mellitus (which includes type 1 and 2), refers to the passing of urine with a high sugar content. In diabetes types 1 and 2, frequent urination occurs in response to high blood sugar and is the body’s attempt to clear excess glucose from the bloodstream. For those with diabetes mellitus, frequent urination is a symptom of a disease rather than the cause. Dehydration is still a serious risk, but it’s not as severe as for those with diabetes insipidus.

It’s probably clear by now that diabetes insipidus is only related to diabetes mellitus in that the symptoms, severe thirst and frequent urination, are the same. Diabetes insipidus doesn’t directly affect blood sugar, but it can cause hypernatremia, which is an over-concentration of sodium in the bloodstream due to lack of water. This condition can cause shock or even death.

Marc says that his condition wasn’t always easy for him to deal with. He describes having “fatigue depression” as a child. He lost interest in his normal activities. Now he uses humor to cope with his daily challenges, and even recalls proudly that as a child he was the only one who could write his whole name in the snow with urine.

Marc is unable to go on long trips or play certain sports because of the risk of dehydration. It would simply be too dangerous to be in a situation where he did not have constant access to water. But Marc maintains a full life. He has a full-time job at an architectural bureau and is heavily involved in his community.

Only about 1 in 25,000 people have diabetes insipidus, making Marc quite a unique case. We appreciate his positive attitude and wish him the best!

Dehydration is a concern for everyone with diabetes. “Next” to learn more.

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Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.