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.

While thalassemia is known widely as a blood disorder, its impact can extend far beyond anemia and transfusions, said experts on World Thalassemia Day today.

World Thalassemia Day is observed every year on May 8 to raise awareness about the inherited blood disorder caused by faulty genes.

The disorder, which often requires blood transfusions every fortnight, affects approximately 1.3 million people living with severe forms of thalassemia worldwide. About 1.5 percent of the global population is carriers, and the disease claims nearly 11,000 lives annually.

Speaking to HealthandMe, health experts raised concerns about the growing mental health and neurological challenges faced by patients, especially children and young adults living with the condition.

Dr. Praveen Gupta, Chairman – Marengo Asia International Institute of Neuro & Spine (MAIINS), Gurugram, shared that repeated blood transfusions are important and save the lives of thalassemia patients, but long-term transfusion therapy can potentially lead to neurological complications if not properly monitored.

“Chronic transfusions can cause iron overload, which is the accumulation of iron in critical organs such as the brain, and may impact cognitive and psychological function, as well as mood,” Dr. Gupta explained.

He added that "changes in oxygen supply and related complications may make patients more vulnerable to headaches, lethargy, or even undetected brain injury".

However, experts stress that most neurological complications can be prevented through multidisciplinary care, iron chelation therapy, and regular monitoring.

Can Thalassemia Affect Brain Development in Children?

The expert stated that thalassemia may also indirectly affect brain development in children, particularly when severe anemia continues for long periods and limits oxygen supply to the growing brain.

Dr. Gupta noted that poor oxygenation, nutritional deficiencies, iron overload from repeated transfusions, and metabolic complications may affect:

• Cognitive function
• Learning ability
• Attention span
• Overall neurodevelopment
• Early warning signs may include:
• Delayed speech
• Difficulty concentrating
• Poor school performance
• Frequent headaches
• Irritability
• Developmental delays

Also read: World Thalassemia Day 2026: Why Screening Before Marriage Or Pregnancy Is Important

Early Signs Parents Should Not Ignore

Dr. Vipin Khandelwal, Sr. Consultant Paediatric Haemato Oncology & BMT at Apollo Hospitals Navi Mumbai, told HealthandMe that thalassemia affects the blood’s ability to carry oxygen, and prolonged disruption can impact growth, immunity, bone health, and learning abilities.

“The early signs of thalassemia are often subtle, which is why many families miss them until anemia becomes severe,” he said.

Parents should watch for persistent symptoms such as:

• Unusual tiredness
• Pale appearance
• Poor appetite
• Difficulty gaining weight
• Delayed growth
• Delayed walking or speech
• Reduced stamina
• Bone pain
• Recurrent weakness

He stressed that while thalassemia is inherited, many serious complications can be prevented with early diagnosis, regular check-ups, timely transfusions, and proper iron monitoring.

Why Depression and Anxiety Are Common Among Thalassemics?

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Further, the experts also highlighted risk of anxiety, stress, low self-esteem, and depression among people with thalassemia who face lifelong blood transfusions, frequent hospital visits, leading to physical fatigue, and fear of complications. Over time, these challenges may increase, many often go unnoticed or untreated.

Dr. Roshan Dikshit, Senior Consultant, Haematology & Bone Marrow Transplant at Aakash Healthcare, told HealthandMe that thalassemia is not only a physical health condition, but also an emotional and psychological challenge. He stressed the need to provide mental support to thalassemic patients.

“Frequent hospital visits, lifelong blood transfusions, fear of complications, and social limitations can increase the risk of anxiety, stress, and depression, especially among teenagers and young adults,” said Dr. Roshan Dikshit, Senior Consultant, Haematology & Bone Marrow Transplant at Aakash Healthcare.

According to Dr. Dikshit, many patients struggle with:

• Low self-esteem
• Isolation
• Emotional fatigue.

Importantly, these emotional challenges often go unnoticed.

“Mental health support should be considered an essential part of thalassemia care. Counseling, family support, social acceptance, and open communication can significantly improve a patient’s emotional well-being and quality of life,” he said.

He also emphasized that early psychological intervention can help patients cope better with the disease and reduce the long-term mental health burden associated with chronic illness.

Many women experience bloating, acidity, stomach discomfort, or constipation from time to time. These symptoms are usually linked to diet, stress, or minor digestive issues. However, these are often overlooked.

On World Ovarian Cancer Day, doctors are urging women to pay closer attention to such recurring symptoms and seek timely medical advice.

World Ovarian Cancer Day is observed every year on May 8 to raise awareness about ovarian cancer and promote early detection. This year’s theme is “No Woman Left Behind.”

According to global estimates, nearly 250,000 women are diagnosed with ovarian cancer each year, and about 140,000 die from the disease.

What Is Ovarian Cancer?

Ovarian cancer is one of the deadliest gynecological cancers and is often referred to as the “silent killer” because its early symptoms are vague and easily mistaken for common digestive or urinary issues.

It develops when abnormal cells in the ovaries grow uncontrollably and may spread to other parts of the body. Survival rates are significantly higher when detected early—around 93 per cent of women diagnosed at stage one survive at least five years, compared to just 13 per cent at stage four, according to the American Cancer Society.

Unfortunately, many cases are diagnosed at advanced stages, when treatment options are limited, and outcomes are poorer.

Early Symptoms Often Overlooked

“Ovarian cancer is commonly called a ‘silent disease’ because its early signs are vague and often resemble routine gastric issues,” Dr. Tejinder Kataria, Chairperson – Radiation Oncology, Medanta Hospital, Gurugram, told HealthandMe.

Common symptoms include:

• Persistent bloating
• Feeling full quickly or reduced appetite
• Pelvic or abdominal discomfort
• Unexplained constipation or diarrhea
• Ongoing indigestion
• Excessive gas
• Abdominal heaviness

Also read: WHO Says 6-Week Hantavirus Incubation Raises Concern, But No Epidemic Risk

One should not ignore these symptoms if they persist for more than two to three weeks.

“Many women delay seeking medical attention because these symptoms feel too common to be serious. Early evaluation through clinical examination, imaging, and blood tests can help detect the disease earlier,” Dr Kaur noted.

“The growing tumor can press on nearby organs such as the intestines or bladder, leading to digestive changes and abdominal discomfort,” she explained.

Risk Factors to Be Aware Of

The experts also highlighted several risk factors that are often overlooked, including:

• Family history of ovarian or breast cancer
• BRCA1 or BRCA2 gene mutations
• Increasing age, especially after menopause
• Reproductive history, such as late pregnancy or never having children

Why Early Detection Matters

Being aware of subtle and persistent symptoms can significantly improve outcomes. Ovarian cancer survival rates are much higher when diagnosed early, making timely medical consultation crucial.

Thalassemia, particularly thalassemia major and thalassemia intermediate, can affect fertility and pregnancy due to iron overload caused by repeated blood transfusions. In these patients, excess iron gets deposited in various endocrine and vital organs, leading to hormonal disturbances and fertility-related complications.

Patients with thalassemia major usually require regular blood transfusions for survival, sometimes every one to three months. Thalassemia intermediate patients may require fewer transfusions, but they too remain at risk of iron overload. Over time, excess iron can accumulate in organs such as the pituitary gland, thyroid, ovaries, kidneys, liver, and suprarenal glands. This iron deposition can impair hormonal function and contribute to infertility. Experts note that many patients with thalassemia major may face fertility issues because of this reason.

Pregnancy In Women Living With Thalassemia

Dr. Sunil Bichile, Hematologist, Saifee Hospital, Mumbai, said, "Although thalassemia management has improved significantly over the years, pregnancy in such patients is still considered high-risk. " Even when iron levels are properly managed, risks to both the mother and fetus may still exist. However, these complications are mainly seen in thalassemia major and thalassemia intermediate patients. Individuals with thalassemia minor generally do not face these fertility or pregnancy-related issues and can have normal pregnancies."

"Doctors also emphasise the importance of carrier screening and prenatal diagnosis. If both partners are thalassemia carriers, prenatal testing around 12 weeks of pregnancy can help determine whether the fetus has thalassemia major. Early diagnosis allows families and doctors to make informed medical decisions and helps reduce severe thalassemia cases," Dr Bichile added.

Ensuring Healthy Pregnancies In Women Living With Thalassemia

Women with thalassemia are now increasingly able to experience healthy pregnancies due to advances in medical care. However, one of the most important concerns during pregnancy in thalassemia patients is iron overload—a condition caused by repeated blood transfusions over many years. Excess iron gets deposited in vital organs such as the heart, liver, and endocrine glands, potentially leading to serious complications if not managed properly before conception and during pregnancy.

How Does Iron Overload Affect Pregnancy?

"Iron overload can significantly increase pregnancy-related risks. When excess iron affects the heart, it may lead to cardiac complications such as arrhythmias or heart failure, which can worsen during pregnancy because of the increased workload on the cardiovascular system. Iron deposition in endocrine glands may also cause hormonal imbalances, affecting fertility and increasing the risk of gestational diabetes, thyroid disorders, or difficulties in maintaining a healthy pregnancy," Dr Liza Bulsara, Pediatric Hematologist and Oncologist, Ruby Hall Clinic, Pune, explained.

Women with poorly controlled iron overload may face a higher chance of miscarriage, fetal growth restriction, preterm delivery, or complications during childbirth. In some cases, liver dysfunction caused by iron accumulation can further complicate pregnancy management. Additionally, anaemia associated with thalassemia itself may increase fatigue and reduce oxygen supply to both mother and baby if not carefully monitored.

Dr Bulsara emphasised that pre-pregnancy counselling is essential for women with thalassemia. A detailed assessment of iron levels through serum ferritin tests and MRI evaluation of the heart and liver helps doctors determine whether the body is prepared for pregnancy. Proper iron chelation therapy before conception plays a crucial role in reducing excess iron stores and improving maternal outcomes. During pregnancy, transfusion schedules, haemoglobin levels, cardiac health, and fetal growth require close multidisciplinary monitoring.