Gestagenic diabetes insipidus (DI) is also known as gestational DI. It is a rare disorder that occurs during pregnancy, usually during the third trimester. Gestagenic DI causes symptoms of both excessive thirst and excessive urination.
With gestagenic diabetes insipidus, you may consume many glasses of water each day. You may also find yourself frequenting the bathroom more than once or twice an hour. But with gestational DI, these feelings of unquenchable thirst and frequent urination are not caused by the pregnancy. Rather, gestational DI is a type of diabetes insipidus or "water" diabetes.
Two years ago, when Jennifer Auyer's father died at age 64 from complications related to type 2 diabetes, she faced a turning point in her own struggle with the disease.
Her father's diabetes had led to heart disease, a quadruple bypass, a foot amputation, and vision problems, among other serious health troubles. "It was a really painful experience, for him and for all of us," says Auyer, 40, of Nashua, N.H.
Four years ago, she, too, was diagnosed with type 2 diabetes, shortly after giving birth...
The symptoms of gestagenic diabetes insipidus are similar to some of the symptoms of the more common diabetes mellitus or "sugar" diabetes. But the two conditions are not related.
What causes gestagenic diabetes insipidus?
Vasopressin, also called antidiuretic hormone (ADH), is a substance in the body that regulates the body's water retention. Although it's rare, sometimes during pregnancy, an enzyme secreted by the placenta can destroy vasopressin. When that happens, the lack of ADH results in excessive thirst and frequent urination. Gestagenic diabetes insipidus may also lead to lack of control in urinating and to bedwetting.
In some cases, gestagenic diabetes insipidus is caused by a deficiency in the body's thirst mechanism. In other cases, gestagenic DI may run in families. And in some cases of gestagenic DI, there is no known cause.
What are symptoms of gestagenic diabetes insipidus?
Most pregnant women find themselves making frequent trips to the bathroom at night due to the increasing pressure of the growing fetus on the bladder. But frequent urination can also be the first sign of gestagenic diabetes insipidus. If it is, it usually correlates with an intense thirst.
Symptoms of too much fluid in the body with gestational DI may include nausea, dizziness, and weakness. If this happens, call your doctor for a medical evaluation.
How is gestagenic diabetes insipidus diagnosed?
To make a correct diagnosis of gestagenic diabetes insipidus, your doctor will first conduct a urinalysis to see if the urine is diluted and not concentrated or yellow. In addition, your doctor may send your blood for laboratory tests. Further testing may be necessary.
How is gestagenic diabetes insipidus treated?
The doctor may prescribe no treatment for gestagenic DI. In that case, your doctor will likely ask that you come to the office frequently. The purpose of the office visits is to make sure your body does not become overloaded with fluid. In addition, you'll need to always keep liquids with you so you don't get dehydrated.
Your doctor may prescribe desmopressin, a synthetic form of ADH. Desmopressin is usually delivered in a nasal spray. This treatment for gestagenic diabetes insipidus helps manage the control of urine. Desmopressin is also used to treat bedwetting, because it allows the body to absorb and manage water from the kidney.
If the body's thirst mechanism is the cause of gestational DI, other treatments may be prescribed.
When should I call the doctor about gestational DI?
Talk with your doctor about the possibility of gestational DI if you are pregnant and experience all of the following symptoms:
You find yourself making frequent trips to the bathroom, especially at night.
You are excessively thirsty.
You are drinking more than your normal daily amount of fluids.
Most cases of gestagenic DI go away four to six weeks after the mother gives birth. However, when gestagenic diabetes insipidus occurs in one pregnancy, it may also occur in future pregnancies.
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