DIABETES INSIPIDUS - Treatment



Treatment of central diabetes insipidus de­pends to a large extent on the severity of the hor­mone deficiency. In patients in whom the defi­ciency is only partial, chlorpropamide will potentiate the effect of ADH on the renal tubule. However, hypoglycemia may result, particularly if the dose of chlorpropamide exceeds 250 mg per day. Patients with more complete hormone defi­ciency require ADH replacement therapy. Long-acting Pitressin Tannate in Oil (warmed and shaken thoroughly), in doses of 5 units intramus­cularly every 48 to 72 hours, has been the standard treatment. More recently a synthetic analogue, 1-desamino-8-D-arginine vasopressin (DDAVP), has become the treatment of choice. Devoid of sig­nificant pressor activity, DDAVP can be conve­niently administered by nasal insufflation in doses of 5 to 10 u.g every 12 to 24 hours. No spe­cific treatment is available for patients with ne­phrogenic diabetes insipidus, but reduction of solute load by salt restriction and administration of thiazide diuretics will reduce the polyuria.