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.

In June 2025, 337 ton of toxic waste from the Union Carbide factory in Bhopal finally left from the city in 12 trucks and arrived at the Pithampura industrial area. The waste was carried in spill-free trucks, but the impact of this toxic waste and the toxic gas on people, still spills today.

As we observe the National Pollution Control Day today, which commemorates the victims of the 1984 Bhopal Gas Tragedy, we also look back onto how its spill on human lives.

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What Happened On December 2 and 3, 1984?

Between December 2 and 3, around midnight, in 1984, there was a massive leak of a poisonous chemical methyl isocyanate (MIC) from a Union Carbide pesticide plant that took thousand lives, and maimed a thousand more, leaving many, even four decades later, impacted.

As per the 1992 study by R Dhara, the gas leak caused chronic inflammatory damage to the eyes and lungs, which was also the main cause of morbidity. Reproductive health problems in form of increased spontaneous abortions and psychological problems were also reported.

The leak was called world's worst industrial disaster. Around 40 ton of toxic methyl isocyanate gas was released into air, and killed more than 3,000 people.

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Those Who Are Still Affected

The toxic waste which had been lying till June this year, as per surveys, contain 6 of the persistent organic pollutants that are banned by the United Nations for their highly poisonous impacts on the environment and human health.

As per the data by the Sambhavna Trust, even after 3 decades, the mortality rate for gas-exposed victims is still 28% higher than the average. The survivors are twice as likely to die of cancers, lung diseases, and tuberculosis. They are also three times as likely to die from kidney diseases and 63% more likely to have illnesses. The data also showed that a 25% of the survivors who had been exposed to the gas were under-active thyroid and can have long-term health impacts.

The explosion also had adverse effects on women, babies, and caused a high rate of infertility, stillbirths, abortions, early menopause and irregularities in menstrual cycles. The Guardian reported that many women left their husbands as they believed "not to be capable of fulfilling the familial duties expected of them".

The Chingari Children's Centre which was established for those born with disabilities due to the gas tragedy registered over 1,000 children. Many of these kids were affected by cerebral palsy, muscular dystrophy, autism, intellectual disabilities, and severe learning difficulties.

A study by the Indian Council for Medical Research (ICMR), found that still 9% of babies who were born between 2016-17 had birth defects. These babies were born to mothers who had been exposed to gas. The Guardian reports that the "study was subsequently discredited by the ICMR, who ordered it not to be published or disclosed."

The Leak That Leaks Even Today

Last year, in September, survivors of the tragedy also visited Harvard TH Chan School of Public Health and shared their stories. The survivors included two women who were children when the gas leak happened, Farhat Jahan and Bati Bai Rajak. They shared that the disaster still continues to leave its impact on the new generation.

A 2023 study published in journal BMJ One also revealed that even after four decades of the tragedy, future generations are afflicted by disabilities and cancer. The study also noted a decline in male births a year after the tragedy, impacting around 100km radius around Bhopal.

Other health conditions include respiratory, neurological, musculoskeletal, ophthalmic, and endocrine issues. The impact also resulted in a 4-fold increase in miscarriages and a higher risk of stillbirth. Researchers from the University of California San Diego also noted that reproductive health impacts could trickle town to future generations, which could be seen even today.

Gordon McCord from the School of Global Policy and Strategy at UC San Diego and the author of the study said that male fetuses are more suspectable to adverse shocks including smog, disease, natural disasters and stressful events during pregnancy. This was reported in media outlet Down To Earth.

Studies also found that men born in 1985 within the 100 km of Bhopal had eight-fold increased risk of cancer.

Another study which analyzed the survivors from 1985 to 1994, titled Health Effects of the Toxic Gas Leak from the Union Carbide Methyl Isocyanate Plant in Bhopal noted for genetic risk of pregnancy outcome in women who were exposed to the toxic gas. The abortion rate was 523 per 1000, immediately after the tragedy. The study also found that infants were born with congenital malformations.

Bhopal gas leak tragedy paved way for a safer workspace and lead to the many laws which aims to protect the survivors, their rights, and also holds the companies accountable for the damage. However, despite this, many survivors still continue to live with chronic pain, diseases, and scarred memories from the tragedy.

This day observed as the National Pollution Control Day is a reminder to why environmental safety is key to health safety, and must alarm the nation for the air pollution situation that continues to worsen by every passing day.

Lots of new developments around weight-loss drugs, with the World Health Organization now stepping in to lower the dosage, and many companies like Eli Lilly actually slashing down the price for better access. Amid this what people may be forgetting are the unusual side effects of being on popular weight loss drugs.

The internet has made room for a lot of unusual confessions, but few are as chaotic, or as oddly supportive, as the Reddit threads where people taking weight-loss jabs like Ozempic and Wegovy openly discuss their most embarrassing side effects. And one theme keeps popping up: unpredictable bowel movements, including the dreaded “sleep sh*ts.”

One Reddit user started a viral thread with a painfully honest plea: “Any advice for not sh*tt*ng in the bed while sleep?” The user said they’d been dealing with this for months and called it “the most annoying side effect.” Another person, already three shots in, nervously listed “sh*tt*ng the bed” as something they were “not looking forward to.”

This mix of diarrhea, constipation, and everything in between has sparked concern, and, for many, shame. But as more people turn to GLP-1 medications for weight loss, understanding why this happens has never been more important.

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Pooping Uncontrollably: It Happens More Often Than You Think

The phenomenon isn’t limited to anonymous Reddit users. A Florida nurse, interviewed by Business Insider, described weeks of constipation so bad she tried “everything from stool softeners to a megadose of Milk of Magnesia.” But by attempting to “hit it from the top and bottom,” she ended up losing control altogether, hence her reluctant membership in the self-appointed “sh*t the bed club.”

Another semaglutide user confessed online: “I quite literally sh*t myself while sleeping… tough few days of diarrhea after my first injection.” And yet, others reported the opposite: stubborn constipation, going days without relief, or passing what one Redditor bluntly called “rocks.”

These extremes highlight one thing clearly, digestive unpredictability is surprisingly common.

Why Do GLP-1 Drugs Mess With Your Gut?

Semaglutide (the active ingredient in Ozempic and Wegovy) is part of a class of medications called GLP-1 receptor agonists. These drugs work by slowing gastric emptying and nutrient absorption so users feel full for longer. But the same mechanism that makes the drugs effective can also confuse the digestive system.

Medical News Today notes that Ozempic often triggers a “stool reflex”, when food entering the gut prompts the colon to clear space. For some people, this reflex becomes unusually strong or overactive, leading to diarrhea.

On the flip side, slowing the gut too much can cause constipation. That’s why Wegovy’s own prescription info reports both diarrhea (30% of users) and constipation (24% of users) during clinical trials.

New York gastroenterologist Dr. Eric Goldstein told Insider that while digestive issues are a known side effect of GLP-1 drugs, the severity seen in social media posts is likely exaggerated because people tend to share the worst-case scenarios. Still, he emphasised that “any medication… may have changes or side effects that need to be monitored.”

How Long Does It Last — And Should You Be Worried?

Fortunately, most people don’t deal with weeks of chaos. According to 2022 research, Ozempic-related diarrhea typically lasts around three days after starting treatment. For the majority, symptoms settle within the first four weeks as the body adjusts. Only 4.3% of people stopped treatment because of GI side effects.

However, flare-ups are common after dose increases, and doctors may recommend slowing dose escalation or adjusting timing if symptoms become disruptive.

Still, experts consistently advise the same thing Reddit does, though with less sarcasm: monitor your symptoms, stay hydrated, avoid greasy or heavy foods, and reach out to your doctor if things become severe or last longer than a few weeks.

The World Health Organization (WHO) has warned that not enough weight loss jabs will be left for those who need it. While weight loss drugs offer a great potential to tackle the obesity issue that is on the rise, globally. However, the accessibility to those who actually need it is fewer than 1 in 10 people.

Worldwide, there are one billion obese people, and are the ones calling for widespread and fairer access to these GLP-1 medication. Health prediction says that by 2030, more than two billion people will be obese unless action is taken seriously.

However, the limited production of the GLP-1 medication, high costs, and supply chain constraints have become a barrier to its universal access. WHO has already added the GLP-1 medication to its 'essential' medicines list for overweight patients with diabetes that countries are advised to provide.

"Our new guidance recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care. While medication alone won't solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms," says WHO director-general Tedros Adhanom Ghebreyesus.

As per WHO, these drugs represent a new chapter in how society approaches obesity from a lifestyle condition to a complex, preventable, and treatable chronic disease. It says these drugs can be used long-term, for six months or more, but they should be prescribed together with guidance on diet and exercise to help people maintain their weight loss. The problem is only few people can actually access them. "Our greatest concern is equitable access," says Tedros.

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How Short Are We On Skinny Jabs?

As of now, WHO notes that under the present scenario of GLP-1 therapies, only 100 million people could benefit them, which is less than 10% of those who need them.

WHO's latest guidelines are now calling on countries and companies to expand access, through strategies and voluntary licensing. This means companies can grant permission for others to make affordable non-brand versions of its patented drug.

A patent on semaglutide, the main ingredient in Novo Nordisk’s Wegovy, is set to expire in many countries in 2026. Once that happens, other manufacturers will be able to produce and sell cheaper versions in markets such as India, Canada, China, Brazil and Turkey.

The WHO also says countries need to build healthier environments that support good health and help prevent obesity.

How Do GLP-1 Medications Work?

GLP-1 drugs mimic the action of the natural hormone GLP-1 to regulate blood sugar and promote weight loss. They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.