Gestational Diabetes Insipidus: A Review of an Underdiagnosed Condition

Diabetes Insipidus: A Review

“…During pregnancy, the placenta produces cysteine aminopeptidase (vasopressinase), which metabolizes both oxytocin and ADH [2]. When cysteine aminopeptidase levels are greatly elevated, ADH is degraded beyond the capacity of the hypothalamic/pituitary axis to secrete it sufficiently to maintain proper urinary concentration [2].…”

“…In cases where polyuria is due to vast amounts of ingested fluids driven primarily by behavioral or thirst disorders, it is called Primary Polydipsia (PP). Pregnant women can metabolize ADH in an accelerated manner leading to Gestational DI [2]. Overall, there are 3 cases of DI per 100,000 in the general population [3].…”

Diabetes insipidus: the basic and clinical review

“…37 Vasopressinase (enzyme) produced by placenta metabolizes the hormones of posterior pituitary both ADH and oxytocin. 38 …”

“…When this cysteine peptidase is produced in large amount, it catabolizes almost 99% quantity of produced oxytocin and ADH leading to GDI. 38 …”

“…It is preffered over pitressin and is resistant to placental vasopressinase. 11,38,61,62 Chlorpropamide also decreases the Polyuria by upto 75% and is used to treat the patients with mild CDI.…”