eMedicine Specialties > Endocrinology > Pituitary Gland

Diabetes Insipidus: Follow-up

Author: Michael Cooperman, MD, Clinical Associate Professor of Endocrinology, Temple University; Chair, Department of Internal Medicine, Division of Endocrinology, Jeanes Hospital
Contributor Information and Disclosures

Updated: Sep 25, 2009

Follow-up

Further Inpatient Care

  • Monitor for fluid retention and hyponatremia during initial therapy. Follow volume of water intake and frequency and volume of urination and inquire about thirst.
  • Monitor serum sodium, 24-hour urine volumes, and specific gravity.
  • Request posthospitalization follow-up visits with the patient every 6-12 months.
  • Patients with normal thirst mechanisms can usually self-regulate.

Prognosis

Prognosis is excellent, depending upon underlying illness.

Patient Education

Patients must be instructed in simple principles of water balance to avoid dehydration and water intoxication (if not carefully monitoring water intake).

Miscellaneous

Medicolegal Pitfalls

The major issues are those of clarifying the diagnosis and etiology of diabetes insipidus, establishing appropriate therapy, and, most importantly, following up on a regular basis to monitor therapy.

 


More on Diabetes Insipidus

Overview: Diabetes Insipidus
Differential Diagnoses & Workup: Diabetes Insipidus
Treatment & Medication: Diabetes Insipidus
Follow-up: Diabetes Insipidus
References
Further Reading
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References

  1. Earley LE, Orloff J. The mechanism of antidiuresis associated with the administration of hydrochlorothiazide to patients with vasopressin-resistant diabetes insipidus. J Clin Invest. Nov 1962;41(11):1988-97.

  2. Kristof RA, Rother M, Neuloh G, et al. Incidence, clinical manifestations, and course of water and electrolyte metabolism disturbances following transsphenoidal pituitary adenoma surgery: a prospective observational study. J Neurosurg. Feb 6 2009;[Medline].

  3. Seckl J, Dunger D. Postoperative diabetes insipidus. BMJ. Jan 7 1989;298(6665):2-3. [Medline].

  4. Hadjizacharia P, Beale EO, Inaba K, et al. Acute diabetes insipidus in severe head injury: a prospective study. J Am Coll Surg. Oct 2008;207(4):477-84. [Medline].

  5. Spanakis E, Milord E, Gragnoli C. AVPR2 variants and mutations in nephrogenic diabetes insipidus: review and missense mutation significance. J Cell Physiol. Dec 2008;217(3):605-17. [Medline].

  6. Hedrich CM, Zachurzok-Buczynska A, Gawlik A, et al. Autosomal dominant neurohypophyseal diabetes insipidus in two families. Molecular analysis of the vasopressin-neurophysin II gene and functional studies of three missense mutations. Horm Res. 2009;71(2):111-9. [Medline].

  7. Richardson DW, Robinson AG. Desmopressin. Ann Intern Med. Aug 1985;ID - NIH5M01(2):228-39. [Medline].

  8. Vande Walle J, Stockner M, Raes A, et al. Desmopressin 30 years in clinical use: a safety review. Curr Drug Saf. Sep 2007;2(3):232-8. [Medline].

  9. Ausiello JC, Bruce JN, Freda PU. Postoperative assessment of the patient after transsphenoidal pituitary surgery. Pituitary. 2008;11(4):391-401. [Medline].

  10. Charmandari E, Brook CG. 20 years of experience in idiopathic central diabetes insipidus [letter]. Lancet. Jun 26 1999;353(9171):2212-3. [Medline].

  11. Czernichow P, Robinson AG. Diabetes insipidus in man. Frontiers of Hormone Research. 1985;13-24.

  12. Pivonello R, De Bellis A, Faggiano A, et al. Central diabetes insipidus and autoimmunity: relationship between the occurrence of antibodies to arginine vasopressin-secreting cells and clinical, immunological, and radiological features in a large cohort of patients with central diabetes insipidus of known and unknown etiology. J Clin Endocrinol Metab. Apr 2003;88(4):1629-36. [Medline].

  13. Robertson GL. Diagnosis of diabetes insipidus. Frontiers of Hormone Research. 1985;13:176-89.

  14. Rose BD. Clinical Physiology of Acid-Base and Electrolyte Disorders. 4th ed. New York, NY:. McGraw-Hill;1994:698-720.

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Further Reading

Related eMedicine topics:
Diabetes Insipidus [Pediatrics: General Medicine]
Hypernatremia [Emergency Medicine]
Hypernatremia [Nephrology]
Hypernatremia [Pediatrics: Cardiac Disease and Critical Care Medicine]
Lithium Nephropathy
Pituitary Disease and Pregnancy

Clinical guidelines:
 ACR Appropriateness Criteria® neuroendocrine imaging. American College of Radiology - Medical Specialty Society. 1999 (revised 2008). 11 pages. NGC:007007

Clinical trials:
Copeptin in the Diagnosis and Differential Diagnosis of Diabetes Insipidus. The CoSIP-Study

Pharmacologic Treatment of Congenital Nephrogenic Diabetes Insipidus

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Keywords

diabetes insipidus, antidiuretic hormone, ADH, DDAVP, desmopressin, vasopressin, diabetes urine, arginine vasopressin, central diabetes insipidus, nephrogenic diabetes insipidus, polyuria, polydipsia, hypernatremia, dehydration, craniopharyngioma, pineal tumors, primary intracranial tumors, idiopathic diabetes insipidus

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Contributor Information and Disclosures

Author

Michael Cooperman, MD, Clinical Associate Professor of Endocrinology, Temple University; Chair, Department of Internal Medicine, Division of Endocrinology, Jeanes Hospital
Michael Cooperman, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Clinical Endocrinologists, and Endocrine Society
Disclosure: Nothing to disclose.

Medical Editor

Frederick H Ziel, MD, Associate Professor of Medicine, David Geffen School of Medicine at UCLA; Physician-In-Charge, Endocrinology/Diabetes Center, Director of Medical Education, Kaiser Permanente Woodland Hills; Chair of Endocrinology, Co-Chair of Diabetes Complete Care Program, Southern California Permanente Medical Group
Frederick H Ziel, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Endocrinology, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Federation for Medical Research, American Medical Association, American Society for Bone and Mineral Research, California Medical Association, Endocrine Society, and International Society for Clinical Densitometry
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Romesh Khardori, MD, Chief, Division of Endocrinology, Metabolism and Molecular Medicine, Professor, Department of Internal Medicine, Southern Illinois University School of Medicine
Romesh Khardori, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Medical Association, American Society of Andrology, Endocrine Society, and Illinois State Medical Society
Disclosure: Nothing to disclose.

CME Editor

Mark Cooper, MBBS, PhD, FRACP, Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University
Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD, Professor of Medicine, St Louis University School of Medicine
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

 
 
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