Do you know someone who is pregnant and showing signs of diabetes?
Gestational Diabetes Insipidus (GDI) is a condition that occurs only during pregnancy. It is characterised by excessive thirst and excretion of large amounts of highly diluted urine. Reduction of fluid intake seems to have no effect on the number of visits to the toilet.
There are several different types of Diabetes Insipidus, each with a different cause. The most common type is neurogenic diabetes insipidus, caused by a deficiency of arginine vasopressin, which is the antidiuretic hormone. It is this type of DI that is generally associated with gestational diabetes insipidus.
During pregnancy women produce vasopressinase in the placenta, which is an enzyme that breaks down arginine vasopressin. In gestational diabetes insipidus this can become extreme. Most cases of gestational diabetes insipidus can be treated with desmopressin, a medical drug that acts as an antidiuretic, reducing the need to urinate. In rare cases, however, an abnormality in the thirst mechanism causes gestational DI, and desmopressin should not be used in this circumstance.
Diabetes insipidus is also associated with some serious diseases of pregnancy. These are:
pre-eclampsia - high blood pressure in pregnancy and protein in the urine
HELLP Syndrome - a further development of pre-eclampsia
Acute fatty liver of pregnancy
It is absolutely essential that these conditions are treated medically as the lives of mother and baby are at risk. Treatment of gestational diabetes insipidus will generally involve medical supplementation with desmopressin, an antidiuretic that slows down the need to urinate. Also gestational diabetes insipidus tends to settle down on its own a few weeks after the baby is born, though some women may develop it again in later pregnancies. |
