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.

Even as Polycystic Ovary Syndrome (PCOS) got rebranded as Polyendocrine Metabolic Ovarian Syndrome (PMOS), it signals a major shift in how doctors understand and treat one of the most common hormonal conditions affecting women, said health experts today.

Speaking to HealthandMe, the experts noted that from the earlier narrowed focus on ovarian cysts, the transition toward PMOS will better capture the condition’s complex metabolic and endocrine nature.

Dr. Isha Kriplani, Consultant – Obstetrics and Gynecology at Paras Health, said the renaming marks “the beginning of a new era in women's gynecological health.”

What Does PMOS Mean?

Also read: PCOS Is Now PMOS: What The Name Change Means For Millions Of Women

The new name aims to explain the condition more accurately and comprehensively.

Polyendocrine means it affects multiple hormones in the body.

Metabolic refers to issues linked to weight, insulin, blood sugar, and heart health.

Ovarian highlights its impact on ovulation and reproductive health.

Syndrome refers to a group of symptoms occurring together.

In simple terms, PMOS is a hormonal and metabolic condition that can affect periods, fertility, skin, mood, weight, and long-term health.

How Will The Change Impact Women

Dr. Isha stated that the term PMOS acknowledges that the disorder is not solely linked to hormonal imbalance or ovarian dysfunction, but also deeply connected to metabolic health. She explained that many women experience symptoms such as weight gain, skin issues, fatigue, insulin resistance, and hormonal disturbances without necessarily showing ovarian cysts on ultrasonography.

“Rebranding Polycystic Ovary Syndrome (PCOS) into Polyendocrine Metabolic Ovarian Syndrome (PMOS) is the beginning of a new era in women's gynecological health. This is because renaming helps us understand that the complex interplay of this disease is not only about imbalanced hormones but also metabolism,” she told HealthandMe.

Dr. Isha added that the shift could help broaden diagnosis and encourage early intervention to prevent long-term complications such as type 2 diabetes and hypertension. She noted that the new terminology also provides women with a more accurate understanding of the syndrome and encourages treatment strategies focused on addressing the root metabolic causes.

Why The Change To PMOS Was Necessary

Dr. Raina Chawla, Associate Director – Gynecology at Sarvodaya Hospital, told HealthandMe the transition from PCOS to PMOS corrects what she described as one of medicine’s “most persistent misnomers.”

She explained that for years, the term PCOS led many patients to believe the condition was purely ovarian in nature, often resulting in confusion and delays in diagnosis. According to Dr. Raina, the so-called “cysts” seen in PCOS are actually immature follicles that develop as a consequence of the disorder rather than being its primary cause.

Also read: PCOD vs PCOS vs PMOS: Why The Condition’s Name Has Changed Over Time

“The shift from PCOS to Reproductive Metabolic Syndrome (PMOS) is an important move toward correcting one of medicine’s most persistent misnomers,” Dr. Raina said.

She further emphasized that the newer terminology places appropriate attention on insulin resistance and androgen excess, helping doctors and patients approach the disorder as a systemic endocrine and metabolic condition rather than a localized ovarian issue.

Experts believe the change in terminology could also reduce stigma and improve awareness about the wide-ranging symptoms associated with the syndrome, while encouraging a more holistic treatment approach that includes lifestyle modifications, metabolic screening, and long-term preventive care.

While there have been meaningful improvements in global health over the past decade, in larger terms, the global health progress continues to be ‘fragile and insufficient’, warned the World Health Organization (WHO) in its new report.

The World Health Statistics 2026 report calls for stronger systems to protect progress.

WHO highlighted several major improvements between 2010 and 2024, including:

• New HIV infections dropped by 40 per cent
• Tobacco and alcohol consumption declined globally
• The number of people needing treatment for neglected tropical diseases fell by 36 per cent

• 961 million people gained access to safe drinking water
• 1.2 billion gained access to sanitation
• 1.6 billion gained access to basic hygiene
• 1.4 billion people gained access to clean cooking solutions

Major Challenges Persist

Despite progress, several global health challenges continue to worsen. These include:

• Malaria incidence has risen by 8.5 per cent since 2015,
• Anemia still affects 30.7 per cent of women of reproductive age, with little improvement over the last decade.
• Childhood overweight prevalence also reached 5.5 per cent in 2024.

“These data tell a story of both progress and persistent inequality, with many people – especially women, children and those in underserved communities – still denied the basic conditions for a healthy life,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“Investing in stronger, more equitable health systems, including resilient health data systems is essential to target action, close gaps and ensure accountability,” he added.

Also read: Another Norovirus Outbreak Confirmed Aboard Cruise Ship In France; Over 1,700 People Trapped

Urgent Need To Protect Progress

The report stressed the urgent need to strengthen universal health coverage (UHC), noting that 1.6 billion people were pushed into poverty due to out-of-pocket healthcare expenses in 2022.

Vaccination coverage also remains below target, contributing to recent measles outbreaks in countries including the US and Bangladesh.

Although maternal mortality has fallen by 40 per cent since 2000, it still remains nearly three times above the 2030 target. Progress in reducing premature deaths from noncommunicable diseases has also slowed since 2015.

Air pollution caused an estimated 6.6 million deaths globally in 2021, while poor water, sanitation, and hygiene contributed to 1.4 million deaths in 2019.

“These trends reflect too many deaths that could have been avoided,” said Dr Yukiko Nakatani, WHO Assistant Director-General for Health Systems, Access and Data.

“With rising environmental risks, health emergencies, and a worsening health financing crisis, we must act urgently – strengthening primary health care, investing in prevention, and securing sustainable financing to build resilient health systems and get back on track.”

Gaps In Health Data

The WHO report also flagged major gaps in global health data collection.

By the end of 2025, only 18 per cent of countries were reporting mortality data to WHO within one year, while nearly one-third had never submitted cause-of-death data.

Of the estimated 61 million deaths globally in 2023, only about one-third included cause-of-death information, and just one-fifth had properly coded International Classification of Diseases (ICD) data.

"While global health efforts are delivering results, progress is fragile and insufficient," stated the report, while stressing the need for accelerated action, stronger health systems, and improved data to renew progress toward the 2030 health goals.

When the name misleads, the disease remains misunderstood. Hence, endocrinologists now propose renaming PCOS as Polyendocrine Metabolic Ovarian Syndrome or PMOS.

This is because the term “Polycystic Ovarian Syndrome” is considered a misnomer. The name makes it sound like the condition is only related to the ovaries. However, over 30% of such patients have normal ovaries. The root lies in the hypothalamus, pituitary, adrenals, pancreas, and adipose tissue — truly polyendocrine.

The cysts in the name are actually antral follicles. The real burden is insulin resistance, dyslipidemia, NAFLD, and a 2-fold higher cardiovascular risk by age 50.

Not just reproductive: PCOS is India’s commonest endocrine disorder — 1 in 5 young women. It drives diabetes, hypertension, depression, and infertility.

PMOS, the acronym, expands as:

P — Polyendocrine: HPO axis + adrenal + insulin + leptin dysfunction

M — Metabolic: Insulin Resistance, obesity, fatty liver, CVD risk

O — Ovarian: Anovulation, hyperandrogenic ovarian dysfunction remains key

S — Syndrome: Heterogeneous, lifelong

This aligns with the 2023 International PCOS Guideline that defines it as a “metabolic + reproductive + psychological disorder”. Yet patients are still told, “You just have cysts.” PMOS reminds every physician to check OGTT, lipids, BP, and mental health at age 18, not 45.

The bottom line is that by changing the name, it is possible to change the game. When a 16-year-old hears “Polyendocrine Metabolic Ovarian Syndrome”, she understands it’s not vanity or infertility alone.