Gestational Diabetes Insipidus

One of the most common forms of diabetes insipidus is the gestational form of this disease. To be fair, it is more like a disorder than a disease, but in rare cases it can become a permanent health issue. Occurring in only women because it is related to a pregnancy, gestational diabetes insipidus can create extreme thirst, higher levels of urination, and may create a higher risk for urinary tract infections and dehydration.

What Causes Gestational Diabetes Insipidus?

Women who become pregnant is the only population demographic that is affected by gestational diabetes insipidus. It occurs when the placenta forms to support the growing fetus inside the womb. The placenta helps to transition nutrients and wastes between mother and child and in most cases, does so quite successfully. In rare instances, however, an enzyme that the placenta produces will destroy a hormone within the mother that controls how fluids are expelled through the kidneys and out of the body.

This hormone is called Vasopressin and it is classified as an anti-diuretic hormone, or ADH. When you feel thirsty, then there are higher levels of ADH in your body because this prevents the body from expelling fluids that your body may need. When there are lower levels of ADH, then there is a more frequent need to urinate.

When gestational diabetes insipidus is present, the enzyme that the placenta produces destroys enough Vasopressin that the mother’s body believes that it should be expelling water at all times. In response, the body begins to dehydrate and so the mother begins to feel thirsty. This causes her to drink more fluids, which creates more urine, which creates more bathroom stops – and then the cycle continues to repeat throughout the pregnancy.

How Is Gestational Diabetes Insipidus Diagnosed?

Doctors will generally request a urine sample during the initial examination. Questions about your eating and drinking habits will also be asked. A blood sample may also be taken. Women who don’t think they are pregnant, but exhibit the signs and symptoms of gestational diabetes insipidus, may have a pregnancy test ordered as well.

The results of the tests will dictate the treatment options that are taken. If the enzyme from the placenta is disrupting ADH levels, then this will be the underlying cause that is addressed. If hormone levels are normal, genetic testing may be recommended to determine if there may be an ongoing issue that could also be passed to the child.

How Is Gestational Diabetes Insipidus Treated?

For many women, there will be no treatment protocol initiated other than more frequent visits to the doctor to track the pregnancy. Most women can handle the disease pretty well and adapt to changing fluid needs until the pregnancy comes to term. Doctors will just want to make sure the mother’s body is not retaining water and creating the conditions for water intoxication. If this occurs, women will just need to have fluids on-hand whenever they feel thirsty.

When an extreme thirst and extreme need for urination are put together, there is the chance that gestational diabetes mellitus may be present instead. A sugar serum drink may be consumed as part of the testing process to eliminate this possibility.

If gestational diabetes insipidus has been confirmed, then another treatment option is to prescribe a synthetic hormone called Desmopressin. It acts the same way as Vasopressin does as an ADH and helps to manage urination because it tells the body to absorb more of the fluids that it is trying to expel. This drug usually comes in a nasal spray form, but may be taken as tablets or through injections.

If thirst control is an issue, then specific treatments based on your medical history will be prescribed.

Will Gestational Diabetes Ever Go Away?

Most cases of gestational diabetes insipidus will resolve on their own in 4-6 weeks after the pregnancy resolves. In rare instances it may continue on for an indefinite period of time and require ongoing treatments. Once a woman comes down with gestational diabetes, there is a higher risk of it developing in future pregnancies as well.

The health risks of gestational diabetes insipidus are often minor. As long as dehydration is avoided and electrolyte balances are maintained, no permanent damage will occur to the mother’s body. If you see urine that is pale or clear on a consistent basis, seem thirsty all the time, or find that you are making frequent trips to urinate at night, then schedule an appointment with your doctor right away. This way you can have peace of mind and hopefully find a way to resolve the bothersome symptoms.