Concerns about the safety of patients with diabetes insipidus admitted to hospital

Abstract

combination with human Chorionic Gonadotropin (hCG) in inducing increased testicular volume and spermatogenesis in adult men with hypogonadotropic hypogonadism who remain azoospermic when treated with hCG alone. In: ClinicalTrials.gov [Internet]. [cited 2015 September]. Available from: http://clinicaltrials.gov/show/NCT01709331 6 Vermeulen, A., Verdonck, L. & Kaufman, J.M. (1999) A critical evaluation of simple methods for the estimation of free testosterone in serum.

Diagnosis and management of diabetes insipidus for the internist: an update

“…Results of a retrospective audit of patients hospitalized with central DI showed that desmopressin treatment had been missed or delayed in 88% of admissions and that 35% of patients consequently developed dysnatraemia [79]. This was attributed to a lack of understanding of the critical nature of desmopressin amongst clinical staff [80].…”

Diabetes insipidus and the use of desmopressin in hospitalised children

“…A paediatric endocrinologist should be contacted as soon as possible after admission. Given the potential risk of morbidity and mortality as a result of failure to adhere to simple principles, in particular with out-of-hours and unplanned admissions, we recommend that a hospital alert system for patients with DI is established in line with the recommendations from NHS England 1 2…”

“…It is important to ascertain whether a patient on desmopressin is also on steroid replacement medication 2. Cortisol is required for the excretion of free water.…”

“…Over a 7-year period, the UK National Reporting and Learning System had identified 76 near misses, 56 dosing errors leading to harm and 4 cases where desmopressin omission has resulted in severe dehydration and death 1. Gleeson et al ,2 concerned about the care of adult patients with DI when admitted to hospital, recently reported a retrospective audit in which desmopressin was missed or delayed in 88% of admissions in two-thirds of cases because medication was unavailable. Both publications raise awareness of the risks and call for improved education, easier access to desmopressin in the inpatient setting and heightened pharmacovigilance using increasingly popular e-prescribing to flag patients on desmopressin and alert endocrinologists to their admission 1 2…”

ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia

“…-In 2018, the Society for Endocrinology (SfE) published guidelines on in-hospital management of central DI 15 . This report was prompted by a study of patients hospitalized with central DI, which showed that desmopressin treatment had been missed or delayed in 88% of admissions, and that 35% of patients consequently developed dysnatraemia 16 . This was attributed to a lack of understanding of the critical nature of desmopressin amongst clinical staff 17 .…”