Author Archives: Dr. Kiran Kishore

About Dr. Kiran Kishore

Dr. Kiran Kishore (M.D., MBBS) is a Consulting Physician and Diabetologist at Srinivasa Clinic & Diabetes Care Center, Hyderabad. He also serves as the Assistant Professor at Bhaskar Medical College. Dr. Kishore specializes in Pharmacology and Diabetology, and has over six years of experience as a Diabetologist.

Diabetes Insipidus Diagnosis – Zeroing In On The Condition

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Diabetes insipidus is a medical condition in which the kidneys are unable to retain water in the body. This condition affects adults as well as children. Diabetes insipidus diagnosis is based on the observation of the clinical diabetes insipidus symptoms and the results of laboratory tests.

diabetes inspidus diagnosis

Frequent and excessive thirst is noted as an important symptom in diabetes insipidus diagnosis.

Diabetes Insipidus Diagnosis – The Types Of The Condition

Diabetes insipidus diagnosis may reveal either a case of central diabetes insipidus or nephrogenic diabetes insipidus, based on the activity of ADH. ADH or Anti Dieuretic Hormone, also known as vassopressin, controls the amount of water conserved by the body.

Central diabetes insipidus can be the result of a deficiency of ADH, while nephrogenic diabetes insipidus usually results when the kidneys do not function properly in response to ADH. Sometimes it may also be a result of the use of drugs like Lithium and Amphotericin B.

Diabetes Insipidus Diagnosis – The Symptoms Experienced

Here is a list of symptoms a person with diabetes insipidus may experience.

  • Polyuria

    The person may pass excess urine, which is often colorless. The amount of urine passed can range from 3 liters in mild cases to up to 20 liters in severe cases. The frequency of urination is as high as 15-20 minutes.

  • Polydipsia

    He may feel excessively thirsty and dehydrated despite drinking lots of water frequently.

  • Disturbed Sleep Pattern

    The person may have trouble sleeping, as he frequently feels the urge to urinate. This results in a disturbed sleep pattern and drowsiness during daytime.

  • Fatigue

    Due to the disturbed sleep pattern, he may feel tired all the time and also experience difficulty in carrying out routine activities. This can also lead to irritability and a loss of concentration.

  • Malaise

    A person with diabetes insipidus can end up feeling vaguely unwell most of the time for no apparent reason.

Diabetes Insipdus Diagnosis – Additional Symptoms In Children

It is quite challenging to identify the symptoms of diabetes insipidus in children, as most of them cannot express their symptoms. Diabetes insipidus diagnosis becomes twice as difficult in children who have not learnt to speak. In such cases, parents can make the diagnosis easier by looking for the following symptoms in their child.

  • The child continues to cry persistently, even after he has been fed, and without the presence of any previously diagnosed medical problems
  • The sleep pattern of the child is disturbed and the child appears frequently irritable
  • The child is not gaining weight with age as expected and instead has weight loss
  • He frequently contracts infections and fever
  • The child wets the bed despite being at a sufficiently advanced age
  • He gets tired easily and frequently

Laboratory Tests Involved In Diabetes Insipidus Diagnosis

  • The estimation of urinary electrolytes such as sodium, chloride, and calcium
  • The measurement of serum osmolality
  • The observation of specific gravity on the first morning void of urine (low in cases of diabetes insipidus)
  • 24 hour urine collection (urine volume is higher than normal in cases of diabetes mellitus)
  • The measurement of urinary and blood glucose to differentiate diabetes insipidus from diabetes mellitus
  • The testing of the serum creatinine to evaluate the possibility of other kidney diseases
diagnosis of diabetes insipidus

An observation of a constant sense of fatigue and malaise can help in the diagnosis of diabetes insipidus.

Children with diabetes insipidus may suffer from continued weight loss, vomiting, and diarrhea if the condition is left untreated. If an adult with the condition has not been treated, he can still remain healthy as long as he compensates for the persistent loss of water from the body. But he always carries the risk of dehydration. A loss of potassium can also occur in such cases. It is best to seek timely diabetes insipidus diagnosis and subsequent treatment for the condition to ensure optimal health.

Gestational Diabetes Complications – The Effects of the Disease

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Gestational diabetes mellitus (GDM) occurs during pregnancy and is characterized by an increase in blood sugar levels. As the causes of GDM are varied, doctors recommend every pregnant woman to get screened for this condition. If GDM is left undiagnosed and untreated, it can lead to various gestational diabetes complications in the mother as well as the fetus.

gestational diabetes complications

Jaundice in the fetus or the newborn is one of the potential gestational diabetes complications.

Gestation Diabetes Complications You Need To Be Aware Of

  • Gestation Diabetes Complications In The Mother

    Gestational diabetes complications in the mother could include one or more of the following.

    • Vaginal bleeding: GDM may lead to the disruption of the placenta (the organ that links the blood circulation of the mother and the fetus) leading to vaginal bleeding. This may also cause pain in the abdomen
    • Premature labour: Diabetes during pregnancy may lead to the premature delivery of the baby
    • Cesarean deliveries: GDM often results in large sized babies. This could hamper vaginal delivery of the baby and call for a cesarean section delivery
    • Miscarriage
    • Hypertension
    • Development of diabetes at a later point in life

  • Gestation Diabetes Complications In The Fetus

    Gestational diabetes complications in the fetus include:

    • Macrosomia: Gestational diabetes increases the risk of the baby being large for its gestational age i.e. weighing more than 4kg. This is known as macrosomia and it is caused due to the over nutrition of the baby
    • Neonatal hypoglycemia  The baby’s blood sugar can drop very low after birth, since it does not receive the requisite amount of blood sugar from the mother
    • Increased risk of trauma to the baby during delivery due to its larger than normal size
    • Congenital malformations: Diabetes can affect the developing fetus throughout the pregnancy. In early pregnancy, diabetes in the mother can result in birth defects (often in the brain and heart) and an increased rate of miscarriage
    • Jaundice, which is caused due to the accumulation of a waste product called bilirubin in the baby’s blood
    • Respiratory distress syndrome: The baby’s lungs are not fully developed and cannot provide enough oxygen to the rest of their body, causing respiratory distress
    • Hypocalcemia, characterized by decreased levels of calcium in the baby
    • The possibility of the child growing up to be obese
    • Development of diabetes at a later point in life

    complications of gestational diabetes

    The complications of gestational diabetes may force the premature delivery of the baby.

With proper treatment, it is absolutely possible to have a healthy baby despite having gestational diabetes. If you’re an expectant mother, it is recommended that you get screened for GDM through a gestational diabetes test as per the advice of your obstetrician, to avoid potential gestational diabetes complications. Following a diet for gestational diabetes is also a step in the right direction.

The Causes Of Gestational Diabetes – Some Details on the Triggers

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Gestational Diabetes Mellitus (GDM) is a condition characterized by an increase in blood sugar levels during pregnancy. While the causes of gestational diabetes can affect any pregnant woman, there are some factors that make certain women highly susceptible to the condition. Some of these triggering factors include:

  • Obesity
  • A family history of diabetes mellitus
  • Previous delivery of a baby with birth weight more than 4 kilograms
  • The presence of glucose in the urine (glycosuria)
causes of gestational diabetes

High risk factors like obesity are some of the causes of gestational diabetes.

The Common Causes Of Gestational Diabetes

GDM can be caused by the dysfunctioning of the beta cells (cells that secrete insulin) of the pancreas. Some of the other causes of gestational diabetes include:

  • Autoimmune Causes

    A study conducted in women with gestational diabetes mellitus revealed the presence of self-destructing (autoimmune) antibodies. These are directed against the pancreatic islets and are called anti-islet antibodies. Due to the presence of these antibodies, the insulin secretion is inadequate and fails to match the increased insulin demand that is seen during pregnancy. This leads to gestational diabetes mellitus.

  • Monogenic Causes

    The autosomes and mitochondrial DNA present in the body regulate insulin secretion. Some of the important genes involved in this process are glucokinase, hepatocyte nuclear factor 1α, and the insulin promoter factor 1. Detailed metabolic studies have revealed abnormalities in glucose-mediated insulin secretion due to mutations in these genes. Such abnormalities can lead to a decrease in insulin secretion and in turn lead to gestational diabetes mellitus.

  • Insulin Resistance

    This is a major factor that triggers gestational diabetes mellitus, as the body’s sensitivity to insulin decline with the progress of the pregnancy.

    Studies have revealed increased circulating levels of leptin and the inflammatory markers TNF-α and C-reactive protein, and decreased levels of adiponectin in women with gestational diabetes mellitus. Increased content of fat in the liver and muscle has also been reported in women with a history of gestational diabetes. Women with GDM show variation in genetic coding for:

    • Glucokinase, which is important for the response produced by the beta cells in the presence of glucose
    • Calpain-10, which is commonly associated with non insulin-dependent diabetes mellitus, especially in Hispanic Americans and some other ethnic groups
    • The sulfonylurea receptor 1, which regulates insulin secretion in response to glucose
    • The β3 adrenoreceptor, which is said to be involved in fat regulation in the body
gestational diabetes causes

As gestational diabetes causes are varied, all women are advised to undergo screening for GDM.

If GDM is left untreated, it can cause various complications both during and after the pregnancy. As the causes of gestational diabetes are varied, it is advisable for every pregnant woman to undergo screening for GDM.

The Right Diet For Gestational Diabetes – Tips For Healthy Eating

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Gestational Diabetes Mellitus (GDM) is characterized by an increase in blood sugar levels, and this occurs in various degrees. This type of diabetes is first detected during pregnancy through gestational diabetes symptoms. GDM occurs due to a drop in the supply of insulin, especially when the supply is inadequate to meet the tissue demands for normal blood glucose regulation. The condition can be managed by planning a good diet for gestational diabetes.

diet for gestational diabetes

A healthy breakfast is a must-have in a diet for gestational diabetes.

Why Follow A Diet For Gestational Diabetes?

Dietary modification plays a vital role in the management of gestational diabetes mellitus. This adds on to the advantages of treatment with insulin therapy by keeping the blood sugar levels under check. The main aims of dietary modifications are:

  • To maintain normal blood sugar levels
  • To maintain adequate nutrition
  • To maintain the desirable body mass index (BMI)

Framing A Diet For Gestational Diabetes

The major nutrients in any diet – carbohydrates, protein, and fat, have a net affect on blood glucose levels. For this reason, it is necessary to have the right balance of these nutrients in your diet. A balanced diet (that has all the vital nutrients), regular insulin, and physical activity are the three factors that help maintain best blood sugar levels.

It is also important to keep the carbohydrate content of the diet consistent on an everyday basis for the same reason. This is because carbohydrates are digested quickly and they often contribute to an increase in the blood sugar level.

The right diet for gestational diabetes should be a balanced diet that mainly contains carbohydrates (60-70%), fat (15-20%), proteins (20-25%), and dietary fibre (25gms/1000Kcal).

Tips For Charting A Diet For Gestational Diabetes

Here are some dos and don’ts you should note when it comes to choosing a gestational diabetes diet plan.

Remember that you should not:

  • Eat too much, without regular intervals
  • Drink soda or other sugary drinks
  • Eat fast foods frequently, or outside food
  • Eat high-fat dairy products
  • Eat unhealthy fats and oils
  • Buy red meat
  • Skip breakfast

Here’s what you should do:

  • Eat smaller servings at regular intervals
  • Drink water or diet drinks
  • Eat less fast food, no more than once a week
  • Prepare more meals at home
  • Switch to 1% or non-fat milk, yogurt, cheese, and frozen yogurt
  • Try fish, chicken, or turkey instead of red meat items
  • Switch to healthier oils like olive and canola
  • Plan and have a healthy breakfast every day

If diet management does not control your blood sugar levels, you may be prescribed insulin therapy. Most women who develop gestational diabetes will not need diabetes medicines or insulin, but some will. Ensure that you consult your doctor whenever you’re confused on what to include in your diet for gestational diabetes.

Gestational Diabetes Symptoms – Signs That Indicate A Problem

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Gestational diabetes mellitus (GDM) is a condition that is associated with an increase in blood sugar levels in a pregnant individual. Gestational diabetes symptoms are exhibited when the insulin supply in the body decreases to a level where it is inadequate to meet the demand for normal blood glucose regulation.

gestational diabetes symptoms

Blurred vision, caused by damage to the ocular blood vessels, is one of the gestational diabetes symptoms.

This problem varies from diabetes mellitus through the fact that it is first diagnosed during the pregnancy cycle.

The Main Gestational Diabetes Symptoms

There are many signs and symptoms associated with gestational diabetes that might indicate the presence of a problem. These can lead on to cause gestational diabetes complications over time. These have been given below.

Frequent Urination, Increased Thirst, Dry Mouth

Women who suffer from gestational diabetes will face the need to frequently urinate, to clear the excess sugar in the blood. Along with the clearance of glucose, the loss of water in the form of urine leads to dehydration. This results in the person experiencing intense thirst and a dry mouth.

Increased Hunger

Despite an adequate intake of food, gestational diabetes is characterized by an increase in hunger. This is due to the failure of the cells to utilise the glucose in the blood, due to the lack of insulin.

Unexplained Weight Loss

Women with gestational diabetes might significantly lose weight, and such weight loss might appear unintentional and in no way related to their diet or exercise routine. This is due to the inability of the cells to utilise glucose.

Fatigue

Feeling weak and tired even after completing minimal work is one of the main gestational diabetes symptoms.

Blurred Vision

Excess glucose in the blood causes damage to the blood vessels in the eyes. This leads to retinal damage, causing a disruption in normal vision.

Frequent Infections Of The Skin, Urinary Tract, Or Vagina

Elevated blood sugar levels lead to an increased amount of glucose in all bodily secretions. This also weakens the normal immunity of the body, causing frequent infections.

Nausea And Vomiting

Nausea and vomiting rank among the minor gestational diabetes symptoms. This symptom is independently non-conclusive, but points towards gestational diabetes when it accompanies the other symptoms.

If experience any of these symptoms during pregnancy, you should consult your healthcare provider so that further evaluation can be carried out through a glucose tolerance test. This gestational diabetes test is usually done to screen people for the condition. The risk factors which can cause GDM are:

  • Obesity
  • Family history of diabetes mellitus
  • Previous delivery of an overweight baby (more than 4 kilograms)
  • The presence of glucose in urine (glycosuria)

Once the gestational diabetes symptoms start showing, a glucose tolerance test can help in confirming the condition.

Diabetes Insipidus Treatment Measures – Hormones That Help

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Diabetes insipidus is a medical condition in which the kidneys are unable to retain water in the body. Before you check out the various diabetes insipidus treatment options, it is essential to understand the condition first.

diabetes insipidus treatment

Keeping your body hydrated with plenty of fluids is highly recommended for diabetes insipidus treatment.

Some Brief Facts On Diabetes Insipidus

The amount of water conserved in the body is controlled by the Antidiuretic Hormone (ADH), which is also called vasopressin. Diabetes insipidus often results due to ADH deficiency, and in such cases, it is called Central Diabetes Insipidus. It might also occur when the kidneys do not function properly in response to ADH, and in such cases, it is called Nephrogenic Diabetes Insipidus.

Sometimes, the problem may be a result of drug usage, especially drugs like Lithium and Amphotericin B. This condition affects adults as well as children.

The common symptoms you may experience in diabetes insipidus are polyuria, polydipsia, and easy fatigability. In children, there may be additional symptoms like excessive crying and bedwetting.

Diabetes Insipidus Treatment Measures

Diabetes insipidus treatment measures can be divided mainly into two types – general measures and hormonal therapy.

General Diabetes Insipidus Treatment Measures

    • Maintaining Hydration

      The most common problem associated with diabetes insipidus is dehydration. The excessive loss of fluid due to polyuria often causes the deficit in the body. You need to keep your body well hydrated by consuming sufficient amounts of fluids. However, it is also very important that you do not drink too much water, as excessive water consumption can cause serious side effects.

    • Maintaining Body Weight

      You could experience a drop in your body weight as well due to the amount of water lost from the body. You can keep this in check by consuming enough fluids.

As a precautionary measure, it is always advisable to carry an identification card if you suffer from diabetes insipidus. This card should have information about your name, address, the medical condition that you have, and the medications you are taking. This will ensure that you get immediate medical help when you need it.

Hormonal Diabetes Insipidus Treatment Measures

As discussed above, in some cases, diabetes insipidus can be the result of a deficiency of the anti diuretic hormone vasopressin. This hormone is responsible for retaining water in the body. The medication used to treat this disorder is called desmopressin acetate (DDAVP), which is similar to the antidiuretic hormone (ADH). DDAVP can be administered by injection into the muscle or by nasal spray. There are newer medications like Terlipressin, Lypressin, and Felypressin which are similar to DDAVP.

Sometimes diabetes insipidus can be controlled with drugs that stimulate the production of antidiuretic hormones such as chlorpropamide, carbamazepine, and clofibrate.

In the case of people who suffer from nephrogenic diabetes insipidus, water pills (thiazide diuretics) may be used. Thiazide diuretics have been shown to stimulate the production of a hormone that helps the body retain salt, and this additional salt prevents the loss of water in the body.

Through these diabetes insipidus treatment measures, the disease can be effectively controlled and managed. It is important to follow your physician’s instructions before proceeding with these measures.

What Is Diabetes Insipidus? – The Bare Basics You Need To Know

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Diabetes insipidus is a medical condition in which the kidneys are unable to retain water in the body, and this happens when there’s an Antidiuretic Hormone (ADH) deficiency. The hormone helps the body retain water, and changes in its level can affect the body adversely. To learn more about what is diabetes insipidus, you should first be aware of its types.

what is diabetes insipidus

If you know what is diabetes insipidus, you might have heard that polydipsia is one of its symptoms.

There are two types of diabetes insipidus:

  • Central Diabetes Insipidus
  • Nephrogenic Diabetes Insipidus

Sometimes, the condition may also result due to the use of drugs like Lithium and Amphotericin B. It affects adults as well as children.

What Is Diabetes Insipidus Caused By?

Central Diabetes Insipidus

Central diabetes insipidus can be caused by damage to the hypothalamus or pituitary gland as a result of:

  • Brain tumors
  • Head trauma
  • Post surgical damage of brain or associated structures
  • Decrease in size of pituitary gland due to auto antibodies
  • Genetic transmission

The exact cause is not known in 30-50% of people who are affected by central diabetes insipidus.

Nephrogenic Diabetes Insipidus

This type of diabetes insipidus results when the kidneys do not function properly in response to the antidiuretic hormone. This can occur due to electrolyte imbalance, medications, systemic processes, and even kidney disease.

  • Medications like lithium, amphotericin, gentamicin and loop diuretics can cause diabetes insipidus. Lithium accumulates in the collecting tubule cells, interfering with several water/urea channels and impairing urinary concentrating ability.
  • An imbalance of electrolytes like hypercalcemia and hypokalemia can cause diabetes insipidus.
  • Kidney related conditions like obstructive uropathy, chronic kidney disease, post-kidney transplant measures, and infections can cause the disease.
  • Systemic processes like sarcoid, amyloid, multiple myeloma, sickle cell disease, and pregnancy can cause diabetes insipidus.

The Symptoms Of Diabetes Insipidus

Once you’ve understood what is diabetes insipidus and how it’s caused, you should be aware of the symptoms of the disease, in order to spot it properly. The main symptoms are:

  • Polyuria (Excessive urination)
  • Polydipsia (Excessive thirst, in spite of consuming large quantities of water)
  • Disturbed sleep pattern
  • Fatigue

Tests For Diagnosing Diabetes Insipidus

The estimation of urinary electrolytes like sodium, chloride, and calcium can help in diagnosing the condition. Serum osmolality is measured along with the specific gravity for this purpose.

The rate at which the patient urinates over 24 hours is also noted, as the volume of urine will be significantly more in individuals with diabetes insipidus. The glucose levels in blood and urine are also measured to confirm the condition.

Treatment Measures For Diabetes Insipidus

The treatment measures can be divided mainly into two parts: general measures and hormonal therapy.

General Measures

There are two aims that general diabetes insipidus treatment measures seek to fulfil.

  • Maintaining hydration
  • Maintaining body weight

This can be done through the proper intake of fluids and by choosing the right diet, with all the essential nutrients, which will help the body retain its weight.

Hormonal Therapy

If you’ve correctly understood what is diabetes insipidus, you’ll remember that it’s caused by a hormonal deficiency. There are medicines that can help in generating this hormone, and these can be used for hormonal therapy.

The medication used to treat this disorder is called Desmopressin Acetate (DDAVP), and this is similar to ADH. It is usually administered through injections or nasal sprays.

Other medications like Terlipressin, Lypressin, and Felypressin are similar to DDAVP and can be used too.

Drugs like chlorpropamide, carbamazepine, and clofibrate help the body churn out more ADH, and these are used in some cases. Doctors might also prescribe medication that helps your body retain salt, as this can in turn help the body retain water.

By understanding what is diabetes insipidus, you can watch out for the symptoms and stay informed so that immediate treatment measures can be taken in case the disease surfaces.

Gestational Diabetes Mellitus – The Bare Basics About The Disorder

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Gestational Diabetes Mellitus (GDM) refers to an increase in blood sugar levels, to various degrees, during pregnancy. GDM occurs when the tissue demands for normal blood glucose regulation are not met due to inadequate insulin supply.

gestational diabetes mellitus

Gestational diabetes mellitus can lead to premature delivery of the baby.

The Risk Factors Of Gestational Diabetes Mellitus

As a pregnant woman, you are at a high risk of GDM if you have:

  • A history of obesity
  • A family history of Diabetes Mellitus
  • Previously delivered a baby that weighed more than 4 kilograms
  • Glycosuria, a condition in which there is glucose in your urine
  • Auto antibodies, which are self-destructing entities that obstruct the pancreas development by destroying beta cells
  • Certain infections like acanthosis

The Symptoms Of Gestational Diabetes Mellitus

This condition is represented by the following gestational diabetes symptoms:

  • Frequent urination, increased thirst, dryness in the mouth
  • Increased hunger
  • Inexplicable weight loss
  • Fatigue
  • Blurred vision
  • Frequent infections of the skin, urinary tract, or vagina
  • Nausea and vomiting

How To Diagnose Gestational Diabetes Mellitus

Gestational Diabetes Mellitus is diagnosed by conducting an oral glucose tolerance test. The American Diabetes Association recommends that this gestational diabetes test be conducted during the initial antenatal visit (for women with high risk factors) or between 24-28 weeks of pregnancy (in women with no previous history of GDM).

The Complications Of Gestational Diabetes Mellitus

Gestational diabetes complications can affect both the mother and the fetus.

Complications In The Mother

These are the complications that pregnant women with GDM can face.

  1. Vaginal Bleeding: GDM may lead to the disruption of the placenta (the organ that supports the blood circulation of the mother and the fetus), leading to vaginal bleeding. This may also cause pain in the abdomen.
  2. Premature Labor:  Diabetes during pregnancy may lead to premature delivery of the baby.
  3. Cesarean Deliveries: GDM often results in overweight babies, and this could make it impossible or tough for the mother to have a normal vaginal delivery. Delivery through a Cesarean section is recommended in such cases.
  4. Miscarriage: There is a higher than normal risk of miscarriage.
  5. Hypertension: The mother may be prone to hypertension.
  6. Recurrence Of Diabetes: Diabetes may occur again later in life.

Complications In The Fetus

These are the complications that GDM can cause in the fetus.

  1. Macrosomia: Gestational Diabetes Mellitus increases the risk of the baby being large for its gestational age, i.e. weighing more than 4 kg  This is known as macrosomia and it is caused by over-nutrition.
  2. Neonatal Hypoglycemia: The baby’s blood sugar can drop to very low levels after birth, since it doesn’t receive the requisite blood sugar from the mother.
  3. Trauma: There is an increased risk of trauma to the baby during delivery.
  4. Congenital Malformations: Diabetes can affect the developing fetus throughout the pregnancy. In early pregnancy, a mother’s diabetic condition can result in birth defects and an increased rate of miscarriage. Many of the birth defects that occur affect major organs such as the brain and heart.
  5. Jaundice: GDM can cause an accumulation of a waste product called bilirubin in the baby’s blood, which can in turn can cause jaundice.
  6. Respiratory Distress Syndrome: In many cases,The baby’s lungs are not fully developed and cannot provide enough oxygen to the rest of his body.
  7. Low Calcium Levels: The calcium levels in the baby’s body are decreased.
  8. Obesity: There is a possibility that the child will grow up to be obese.
  9. Recurrence Of Diabetes: The baby may get diabetes again later in life.

Gestational Diabetes Mellitus Treatment Options

Reducing your weight, following a low-cal diet for gestational diabetes, and getting regular insulin doses can go a long way in helping you counter GDM. With proper treatment, you can deliver a healthy baby despite having diabetes.

If you take proper precautionary measures against gestational diabetes mellitus, especially if you are a high risk candidate, you can make sure that you have a smooth delivery and a normal baby.

Gestational Diabetes Test – Diagnostic Test for Confirmation

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Gestational Diabetes Mellitus (GDM) is a condition in which the blood sugar levels increase to various degrees during pregnancy. GDM occurs due to decreased and hence inadequate insulin supply, to meet the tissue demands for normal blood glucose regulation. This condition should be immediately detected through a test in order to avoid gestational diabetes complications in the mother or the fetus.

gestational diabetes test

The gestational diabetes test helps detect if an expecting mother has acquired diabetes during pregnancy.

The Gestational Diabetes Test

During pregnancy, it is important to undergo blood glucose screening at the initial antepartum visit. If this step has been omitted for any reason, it is wise to have your blood glucose tested as soon as possible.

Gestational Diabetes Test – Those In The High Risk Group

Certain women face a higher risk of gestational diabetes than the rest, such as:

  • Women battling obesity
  • Those with a family history of Diabetes Mellitus
  • Women who have previously had a baby that weighed more than 4 kilograms
  • Those with glycosuria i.e. a condition in which glucose is present in the urine

It is advised to get your blood sugar tested between the 24th and 28th weeks of pregnancy, if you were not diagnosed with Gestational Diabetes Mellitus during previous prenatal checks. This is just a screening process that will help you be sure of your physical condition.

What Happens During The Gestational Diabetes Test

The American College of Obstetricians and Gynecologists recommends screening for GDM during the initial prenatal visit, for women in the high risk groups.

This test is mainly a 50 gram oral glucose test performed in the patients with high risk factors. It does not need any prior preparation and can be done at any time of the day.

The blood glucose level is measured one hour after the test. If the blood glucose levels are ≥ 140 mg/dl or ≥ 7.8 mmol/l, an oral glucose tolerance test is carried out.

The Oral Glucose Tolerance Test

This gestational diabetes test is recommended by the American Diabetes Association. It is carried out during the early prenatal visits in the case of women from high-risk groups, and sometime between the 24th and 28th weeks of pregnancy in others.

If you are planning to undergo this gestational diabetes test, you should fast for at least 8 hours before the test. At the start of the test, 75 g of glucose is administered orally. The test is interpreted as follows:

 

Time

Blood glucose in mg/dl

Blood glucose in mmol/l

Fasting

≥92

≥5.1

At 1 hour

≥180

≥10

At 2 hours

≥153

≥8.5

The values shown in the table indicate a positive glucose tolerance test. If you test positive for gestational diabetes, treatment measures will be started immediately to avoid complications in both your health and the health of the fetus. These treatment measures include framing a right diet for gestational diabetes and the administration of insulin.

While some women face a higher risk of suffering GDM, this condition can occur in any woman during pregnancy. For this reason, it is highly recommended that pregnant women undergo the gestational diabetes test, to avoid harm to themselves as well as their fetus and ensure the birth a healthy baby.

Diabetes Insipidus Causes – What Causes The Disorder

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Before you learn about the diabetes insipidus causes, it is essential to know about the disease and what its symptoms are.

Diabetes insipidus is a condition that brings down the kidneys’ ability to retain water through its natural function. There are two types of this condition, and these have been classified based on the diabetes insipidus causes behind each variant.

The Anti-Diuretic Hormone (ADH) controls the amount of water that they body should retain for its proper functioning. This hormone is also called vasopressin. When a deficiency of this hormone causes a change in the water retention cycle, the condition is called Central Diabetes Insipidus.

When the kidneys in the body don’t function properly and fail to respond to the Anti-Diuretic Hormone, the condition is called Nephrogenic Diabetes Insipidus.

Diabetes Insipidus Causes – What Brings About The Condition

Central Diabetes Insipidus Causes

Central diabetes insipidus is caused due to damage to the hypothalamus or pituitary glands. Such damage is usually brought about by these factors:

  • Brain tumors
  • Head trauma
  • Post surgical complications (of the brain)
  • Self-destructing antibodies (auto antibodies) that decrease the size of the glands
  • Congenital problems (present from infancy)
  • Mutation in the gene that controls ADH function
  • Rare diseases like Histiocytosis X or Sarcoidosis

The causes behind hypothalamus or pituitary damage is not known in around 30-50% of people who are diagnosed with central diabetes insipidus.

diabetes insipidus causes

One the main causes of nephrogenic diabetes insipidus is excessive lithium.

Nephrogenic Diabetes Insipidus Causes

This type of diabetes insipidus results when the kidneys do not function properly. The causes behind this problem could be:

  • Medications: Medications like lithium, amphotericin, gentamicin, and loop diuretics can cause diabetes insipidus. Lithium can accumulate in tubule cells and interfere with water/urea channels, impairing the overall urinary concentrating ability.
  • Electrolyte Imbalance: An imbalance among electrolytes due to conditions like hypercalcemia and hypokalemia can cause diabetes insipidus.
  • Kidney Disease: Conditions like Obstructive Uropathy, Chronic Kidney Disease, and other infections are possible causes. Complications that arise after a kidney transplant can also cause this problem.
  • Systemic Processes: Sarcoidosis, Amyloidosis, Multiple Myeloma, Sickle Cell Disease, and Pregnancy can also impair kidney function.

Rarely, the condition may be congenitally present due to a defect in the individual’s genes or receptors. Learning about such diabetes insipidus causes can help in making an informed decision while broaching the subject of treatment.