Diabetes insipidus (DI) is a rare medical condition that disrupts the body's ability to regulate water, resulting in excessive thirst and an unusually high volume of urine. This condition affects the kidneys' ability to concentrate urine and causes individuals to produce between 3 and 20 quarts of dilute, colourless urine daily, compared to an average of 1 to 2 quarts. It is pertinent to note that DI is not related to diabetes mellitus, which disrupts the body's insulin production.

Types Of Diabetes Insipidus

This condition results from damage to the hypothalamus or pituitary gland, which impairs the production or release of vasopressin, a hormone responsible for water retention. When vasopressin levels are inadequate, the kidneys fail to conserve water, leading to excessive urination. It can result from Brain injuries or surgeries, tumours, infections or inflammation and aneurysms.

Nephrogenic Diabetes Insipidus

This type occurs when the kidneys fail to respond to vasopressin, causing excessive fluid loss. Common triggers include chronic kidney disease, and electrolyte imbalances, such as high calcium or low potassium levels. Additionally, medications like lithium

and urinary tract blockages can also cause Nephrogenic DI.

Gestational Diabetes Insipidus

A rare condition seen only during pregnancy, this occurs when the placenta produces an enzyme that breaks down vasopressin or increases prostaglandin levels, reducing kidney sensitivity to the hormone. Symptoms of this are usually mild and often resolve postpartum but can recur in future pregnancies.

Symptoms And Warning Signs

• Severe thirst, often leading to the consumption of over a gallon of water daily
• Frequent urination (polyuria), sometimes exceeding 20 quarts per day
• Nighttime urination and bed-wetting
• Weakness, muscle pain, and preference for cold drinks

In severe cases, dehydration may develop, manifesting as fatigue, dizziness, dry mouth, confusion, nausea, or fainting. Infants and children with DI may exhibit crankiness, poor feeding, slow growth, fever, or vomiting.

Causes And Risk Factors

DI stems from issues with vasopressin production or response. Central DI arises from damage to brain structures, while nephrogenic DI relates to kidney dysfunction. Risk factors include:

- Genetic mutations affecting water regulation

- Certain medications like diuretics or lithium

- Metabolic disorders that alter calcium or potassium levels

- Brain injuries or surgeries

Diagnosis And Testing

Diagnosing DI involves a combination of medical history, physical exams, and specialized tests:

- Urinalysis: Evaluates urine concentration and glucose levels to distinguish DI from diabetes mellitus.

- Blood tests: Check electrolyte, glucose, and vasopressin levels.

- Water deprivation test: Measures changes in weight, blood sodium, and urine concentration during fluid restriction.

- MRI: Detects abnormalities in the hypothalamus or pituitary gland.

- Genetic screening: Identifies inherited risk factors.

Although DI is rare, affecting about 1 in 25,000 people, early diagnosis and targeted treatment can significantly improve quality of life. Researchers continue to explore its causes and treatments to better support those living with this challenging condition.

With temperatures rising sharply, experts at the All India Institute of Medical Sciences (AIIMS) have warned that young children are significantly more vulnerable to heat stress than adults, urging parents to take preventive measures and recognize early warning signs.

Despite morning showers offering some relief, the national capital still recorded temperatures close to 40°C.

How Extreme Heat Affects Young Kids

Shefali Gulati, Professor, Department of Pediatric Neurology at AIIMS, highlighted that children are predisposed to both heat and cold stress and also tend to get dehydrated more quickly. She noted that global temperatures have been rising over the past few decades, and cited 2020 data from UNICEF, which showed that 76 per cent of children under 18 in South Asia—around 460 million—are exposed to extremely high temperatures, with 83 or more days in a year exceeding 35°C.

Dr. Gulati explained that young children often exhibit early behavioral changes when affected by heat. These can include irritability,

• reluctance to engage in outdoor activities,
• restlessness,
• excessive sweating,
• uneasiness,
• weakness.

She added that heat exposure, when combined with air pollution, can worsen health conditions, particularly in children with lung diseases and asthma.

“Heat can affect all parts of the human body. It begins with irritability and can progress to exhaustion,” she said.

In more severe cases, heat stress may lead to brain exhaustion, loss of consciousness, seizures, dehydration, and electrolyte imbalance.

Dr. Gulati further explained that the human body maintains its core temperature through physiological mechanisms, but these are less efficient in young children. During dehydration, increased blood flow to the skin reduces supply to vital organs like the brain. In patients with pre-existing kidney issues, this can result in acute or chronic injury.

Children with conditions such as cerebral palsy and other neurological disorders may also experience worsening symptoms due to heat exposure.

Further, dehydration can additionally strain the cardiovascular system, thickening blood and leading to tachycardia, thereby affecting cardiac function.

Beyond children, pregnant women exposed to extreme heat may face risks such as preterm birth, neurodevelopmental problems, and cognitive issues in newborns.

Dr Gulati emphasized the importance of fluids, Oral Rehydration Solution (ORS), and small, frequent meals, along with reduced outdoor activity. Preventive measures include wearing loose clothing, avoiding direct sun exposure, and limiting outdoor activities during peak heat hours.

The Importance of Diet: Avoiding Sugary Drinks

Also read: Heat Stroke or Heat Exhaustion? AIIMS Doctor Explains Key Symptoms, How To Prevent

Parmeet Kaur, Chief Dietitian at AIIMS reiterated the importance of proper hydration, food safety, and dietary habits during extreme heat, warning that both children and adults face increased risk of dehydration and related complications.

“One has to avoid consuming extra sugary and salty foods, drinks, and snacks, because if one is consuming highly processed drinks or snacks loaded with sodium and sugar, it may lead to dehydration,” Kaur said.

"Hydration is key, and one should not wait to feel thirsty," she added, stressing the need to consume home-made and simple food.

For immediate management, homemade Oral Rehydration Solution (ORS) can be used, prepared with six teaspoons of sugar and half a teaspoon of salt in one liter of water.

However, she cautioned "against sugary drinks and packaged snacks like chips, explaining that high sugar and sodium content can worsen dehydration while giving a false sense of energy. While these products may create the impression of quick rehydration or an instant energy boost, they can instead contribute to greater fluid loss and increase the risk of severe dehydration.”

Instead, the expert recommended traditional cooling options such as bael sharbat, lassi, sattu, and gond katira. Ingredients like coriander, mint and onion were also suggested as part of summer dietary practices.

The dietician advised small, frequent meals that are easy to digest, including roasted and unsalted chana or peanuts, while avoiding heavy meals.

Food safety is another major concern during the summer. High temperatures increase the risk of microbial growth in stale or improperly stored food.

Kaur warned to "not consume food left at room temperature for more than two hours", as it can lead to microbiological growth. Sprouts were also flagged as potentially risky in hot weather.

Further, the expert also urged for "high heat cooking method with vegetarian food to be cooked at around 70°C, while non-vegetarian items require temperatures between 70°C and 80°C".

The expert reiterated the need to

• maintain hydration levels of approximately 2.5 to 3 liters per day.
• ensure electrolyte balance,
• take preventive action before body temperature rises.

Even as heatwave conditions continue to intensify across parts of the country, cases of heat-related illnesses are on the rise, leaving many confused between heat stroke and heat exhaustion.

While both are caused by prolonged exposure to high temperatures, their severity, warning signs, and management can differ significantly.

Speaking to HealthandMe, Dr. Naval Vikram, Professor, Department of Medicine, at the AII India Institute of Medical Sciences (AIIMS), explained the key symptoms to watch out for, how to tell the difference between the two conditions, and the simple yet crucial steps individuals can take to protect themselves during extreme heat.

“The general features of a patient with heat stroke are: first, his or her body temperature will be very high. It will not be around normal levels like 104, 105, or 106—it will be significantly elevated. Second, the person may be delirious, confused, or even in a state of unconsciousness or coma. The breathing will also be labored. These are the features of heat stroke,” Dr Vikram said.

On the other hand, a person with heat exhaustion remains conscious, but looks and feels very tired. The individual is also likely to experience

• body ache,
• muscle pain,
• headache,
• muscle cramp,
• body pain or fatigue.

"If this has happened after exposure to heat, it is similar to the feeling one gets after jogging, running, or playing for about half an hour and then feeling exhausted. If that same feeling occurs without doing any such activity, then it is a stage of heat exhaustion, because it is happening due to the heat,” Dr Vikram told HealthandMe.

Who Is More At Risk With Heat-related Problems?

The most vulnerable category for heat-related problems is the extremes of age—the younger children and older adults.

The expert noted that younger children may not be able to express their symptoms completely. They may not be able to tell you exactly what they are feeling.

At the other end, older adults often have multiple health issues—neurological conditions, diabetes, hypertension, and kidney problems.

"So multiple organs may already be affected to some extent. In such situations, if heat-related illness occurs, it becomes difficult to diagnose, especially if they already have neurological problems like confusion or altered behavior," Dr Vikram said.

With existing comorbidities, other organs may already be compromised, so the tipping point towards severity happens very quickly. In contrast, younger individuals generally have greater body reserves.

Therefore, people at the extremes of age are more vulnerable, also because it can sometimes be difficult to recognize and diagnose the condition in them.

How Can One Prevent?

While it may be impossible to avoid rising temperatures, the focus should be on how much you can protect yourself. The expert suggested measures such as:

• Try to avoid exposure to extreme heat as much as possible.

• In case of being exposed, make sure to cover yourself—cover your head and upper body, use an umbrella, stay hydrated, and take breaks in between.

• If you have to work in a hot environment for a couple of hours, take a break in a cooler or temperature-controlled environment for at least half an hour before resuming, rather than continuously working in the heat. These steps can help prevent heat-related problems.

• If symptoms do occur, and it is heat exhaustion, take rest and avoid further activity for some time.

• In more severe cases—if someone shows symptoms like loss of consciousness or very high body temperature—they should be taken to a hospital immediately. Do not try to manage such cases at home.”

Complex pesticides can be now be found in food, water and the surrounding environment and while previous research has noted that they can cause damage to vital organs, a new Nature Health study has revealed that high-exposure to such chemicals can increase a person's risk of certain cancers by over 100 percent.

The researchers analyzed 31 pesticides across Peru and compared the health data from more than 150,000 cancer patients recorded between 2007 and 2020 with areas to discover that people living in regions with higher environmental pesticide exposure were 150 percent more at risk of developing cancer. It remains unclear which kind of cancers they are most prone to.

Stéphane Bertani, a researcher in molecular biology at the French National Research Institute for Sustainable Development (IRD), at the PHARMA-DEV laboratory (IRD/University of Toulouse) said of the results: "This is the first time we have been able to link pesticide exposure, on a national scale, to biological changes suggesting an increased risk of cancer."

The study also highlights how pesticide exposure may affect the body long before cancer is diagnosed. Although tumors can develop in different organs, some share underlying biological weaknesses tied to their cellular origins and vulnerabilities which may be influenced by pesticide exposure.

Previous studies conducted at the Institut Pasteur, led by Pascal Pineau, also show that pesticides can slowly interfere with processes that maintain normal cell function and identity.

Over time, these disruptions accumulate without obvious symptoms and make tissues more susceptible to other harmful influences, including infections, inflammation and environmental stress, paving the way for cancer development.

Pesticides Can Also Increase Risk Of Lung Cancer

The research from the University of Southern California, presented at the annual meeting of the American Association for Cancer Research, found that patients under 50 diagnosed with lung cancer often had better-than-average diets. The experts zeroed in on the culprit, pesticide exposure from conventionally grown produce.

"Our research shows that younger non-smokers who eat a higher quantity of healthy foods than the general population are more likely to develop lung cancer," said lead investigator Jorge Nieva, a medical oncologist and lung cancer specialist with USC.

"These counter-intuitive findings raise important questions about an unknown environmental risk factor for lung cancer related to otherwise beneficial food that needs to be addressed," Nieva added.

Pesticides In Healthy Foods — A Hidden Risk

According to the researchers, the reason may lie in environmental exposure, particularly pesticides used in agriculture. Nieva noted that commercially produced (non-organic) fruits, vegetables, and whole grains are more likely to carry higher levels of pesticide residue compared to dairy, meat, and many processed foods.

He also pointed out that agricultural workers who are regularly exposed to pesticides tend to have higher rates of lung cancer, which supports the possibility of a connection.

The study also found that young women who do not smoke are diagnosed with lung cancer more often than men in the same age group. Women in the study also tended to consume more fruits, vegetables, and whole grains than men.