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.

When women are in their 40s, their bodies start to change a lot because of the hormones. This is mainly because the estrogen and progesterone levels in the body start to go down. This time is called Perimenopause.

It is when women start to move towards menopause. It can bring a lot of emotional changes. Some of these changes are normal.

Why Do Hormonal Changes Happen After 40?

After 40, women's bodies start to produce estrogen. This means they can have an imbalance.

Women's bodies need hormones like estrogen and progesterone to have periods, strong bones, a good mood, and to stay at a healthy weight. When these hormone levels change, it affects parts of the body. This change can take a year before it stops at menopause.

Common hormonal changes women experience

• Irregular periods

• Hot flashes and night sweats

• Mood swings and anxiety

• Weight gain and slower metabolism

• Sleep disturbances

• Skin and hair changes

Symptoms That Should NOT Be Ignored

While some changes are normal, some symptoms need a doctor's help:

• Heavy or prolonged bleeding

• Persistent fatigue

• Severe mood changes

• Sudden weight gain

• Bone pain or weakness

When women are over 40 and their hormones change, they are more likely to have:

• Heart disease
• Osteoporosis
• Thyroid disorders
• Metabolic issues

Estrogen helps keep the heart and bones healthy, so when its levels go down, women are more likely to have these health problems."

How Can Women Manage These Changes?

• Eat a balanced diet

• Exercise regularly

• Manage stress

• Have regular health check-ups

• Sleep well

Women should talk about these changes openly. If they know what is happening and see a doctor early, they can make this time easier.

Hormonal changes after 40 are a part of getting older, but women should not ignore them. Especially if the symptoms are very bad or happen all the time.

If women understand what is happening in their bodies and see a doctor when they need to, they can be healthier and more confident. If women take care of themselves now, they can have a life in the years to come.

The US Food and Drug Administration (FDA) has approved tradipitant to be sold under the brand name Nereus, for the prevention of vomiting induced by motion in adults — a first in the last four decades.

Motion sickness affects an estimated 65 to 78 million Americans—roughly 25 to 30 percent of adults—during everyday travel by car, plane, or boat. For decades, patients have had no meaningful new treatment options.

Tradipitant is an oral neurokinin-1 (NK-1) receptor antagonist that prevents motion-induced vomiting in adults.

It is an oral capsule, often taken 60 minutes before travel to block signals causing nausea.

The drug by Vanda Pharmaceuticals is now commercially available across the US.

"Today marks an important milestone for the tens of millions of Americans who experience motion sickness symptoms during common travel," said Mihael H. Polymeropoulos, M.D, President, CEO, and Chairman of Vanda, in a statement.

How Tradipitant Prevents Motion Sickness?

Motion sickness occurs when the brain receives conflicting signals from the eyes, inner ear, and body while in motion. This sensory mismatch is believed to trigger the release of substance P, which activates NK-1 receptors in the central nervous system and ultimately leads to nausea and vomiting.

Tradipitant works by blocking these receptors, interrupting the vomiting pathway.

"NEREUS is a selective, high-affinity antagonist of human substance P/neurokinin-1 (NK-1) receptors that can block the vomiting center of the brain,” Polymeropoulos said.

Tradipitant was approved by the FDA, following two pivotal Phase 3 clinical trials—Motion Syros and Motion Serifos—conducted under real-world conditions on the open sea.

Also read: India Installs US FDA-approved Portable MRI For Bedside Brain Scans At AIIMS Delhi

Both studies demonstrated that tradipitant significantly prevents vomiting compared to placebo, confirming the drug's effectiveness in actual sea travel conditions. It is the first new prescription option for people with a history of motion sickness in over 40 years.

It employs a novel mechanism as a selective, high-affinity antagonist of human substance P/NK-1 receptors. It offers simple dosing with just one or two capsules a day taken approximately an hour before travel.

Is Tradipitant Safe? Are There Any Side-Effects?

Read More: CDC Warns Over Potential Surge In Measles Cases: Will The US Lose Its Elimination Status?

According to Vanda Pharmaceuticals, tradipitant may impair abilities required for driving a motor vehicle or operating heavy machinery.

Combining tradipitant with sedatives or medications that increase the drug's levels may increase this effect. If use together cannot be avoided, your doctor may warn against driving or operating heavy machinery.

The most common side effects associated with tradipitant include drowsiness, headache, and fatigue.

Moreover, strong CYP3A4 inhibitors may increase NEREUS™ levels and the risk of side effects, the company said.

There are limited data on tradipitant's use in pregnant women and children.

Tradipitant is also not recommended in patients with liver problems or severe kidney problems.

Type 2 diabetes was once rare among the young. Now, it is a common diagnosis for Indians in their 20s and 30s. The country currently faces a massive health crisis with 101 million confirmed diabetic patients and 136 million prediabetics. This sudden spike did not happen because human genetics broke down overnight. It happened because the way we live has completely transformed.

Asians (Indians ) already have a " thin- fat " body phenotype, which has a heavy genetic disadvantage. Even when an Indian person appears thin, they typically carry a much higher body fat percentage than a European person of the exact same weight. This fat builds up dangerously as visceral fat around the internal organs. Because of this, Indians develop severe insulin resistance at a much lower Body Mass Index (BMI).

Secondly, we tend to have faster beta-cell exhaustion. The pancreas simply stops producing enough insulin earlier in life.

Thirdly, if you have a positive family history, then the risk is higher and happens at an early age as compared to the previous generation.

But definitely it is not just genetics. Our DNA remains exactly the same as it was a century ago. Still, the age of onset is dropping at an alarming rate. Data from the massive ICMR-INDIAB study reveals that the real "take-off" point for diabetes now sits squarely in the 25 to 34 age bracket. Out of all the people under 25 diagnosed with diabetes today, one in four has Type 2. It used to be very rare to see anything other than Type 1 in young adults.

Now, the situation is completely different. States like Goa, Kerala, and Tamil Nadu are recording huge numbers, especially in city areas. Data collected in Tamil Nadu from 2006 to 2016 proved that the 20 to 39-year-old age group was getting sick at a faster pace than older generations. Across India, the total prevalence rate jumped from 7.1 percent to 11.4 percent. If current trends hold, we are looking at 152 million cases nationwide by 2045.

Why Diabetes Is Rising?

The absolute driver behind this youth explosion is a drastic shift in how we live. Urbanization wiped out physical activity. Young professionals sit at desks for ten hours, endure stressful commutes, and spend their remaining free time staring at screens.

Our diets worsened at the same time. Traditional balanced meals gave way to heavily refined carbohydrates and ultra-processed food, which the younger generation highly depends on. Polished white rice, refined wheat, and cheap ultra-processed foods flood our daily plates. Young people eat far less protein and fiber. This combination of daily sugar spikes and zero physical movement directly causes the abdominal obesity driving this epidemic.

The rapid rise in youth diabetes comes down to a severe gene-environment mismatch. Young Indians live in bodies biologically programmed to store fat to survive famines, but they now live in an environment of constant fast food and zero movement. We cannot rewrite our DNA. We can, however, change our daily habits.

As per RSSDI, early medical screening before age 25 is now an absolute necessity. Replacing heavy carbs with a low-carb, high-protein diet, fixing bad sleep schedules, and making time for daily physical activity can stop this crisis. Youth diabetes is entirely preventable. We just need to act before it is too late.