Know your insipidus from your mellitus

Our summer 2016 diabetes insipidus awareness campaign was Know your insipidus from your mellitus.

It is vital not to confuse diabetes insipidus with diabetes mellitus because they have different causes and very different treatments.

Our campaign highlighted the importance of desmopressin being a lifesaving medication. We targeted A&E staff, nurses and pharmacists working in non-endocrine settings. As well as participants using our template letter to spread awareness locally The Pituitary Foundation also wrote to over 100 hospitals. 

The Pituitary Foundation knows of a couple of patients who have died due to being denied desmopressin in hospital, and many more who have become very unwell as a result of missed medication. 

Overall our campaign has resulted in increased numbers of health care professionals working in non-endocrine settings being aware of Diabetes Insipidus. It will be beneficial to build on the successes of this campaign in future years.  

 

 

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Please note although this campaign is no longer running the resources are still available if you feel awareness needs to be raised in your locality in A&E staff, ward nurses, and pharmacists; all working in non-endocrine hospital settings. Please email campaigns@pituitary.org.uk to be sent a template letter.

Safety concerns

University Hospitals of Leicester NHS Trust recently performed a retrospective audit of adult patients, the findings included:

-       The study showed that one safety concern at least was seen with every hospital admission in patients with diabetes insipidus. This is shocking and as such the study suggests every time a patient is admitted to hospital there is a high risk of a safety concern occurring.

-       88% of patients had missed/delayed administration of desmopressin – this is a very high percentage showing how common it is amongst diabetes insipidus patients.

-       64.9% of missed/delayed administration was due to desmopressin being unavailable in the hospital setting.

The hospital are using these findings of this audit to highlight safety concerns UK wide. Helena Gleeson, Adam Bonfield, Elizabeth Hackett and Winston Crasto have recently published an article in Clinical Endocrinology magazine entitled ‘Concerns about the safety of patients with diabetes insipidus admitted to hospital’. The findings of this study have helped fuel The Foundations campaign and are included in the template letter we are asking participants to send out.

 

An example from a patient The Pituitary Foundation spoke with on the Helpline: The patient was admitted to A&E after a fall at 9:30am, their last desmopressin dose was bedtime the night before. Their next dose is due around 10:00am and they haven’t got this with them in the emergency admittance. In A&E – tests, waiting, tests, waiting – it’s now 1:00pm and through this time the patient has asked for bed pans every 20 -30 mins; they have also asked for water but it’s been denied in case of any surgery needed. They try to explain about diabetes insipidus but this is not acknowledged. At 1:30pm they are given tiny sips of water controlled by A&E staff – they are fully dehydrated now and begging for more water. This is refused, also their desmopressin is refused by pharmacy as the condition is not understood. They need fluids – desperately. Luckily the patient’s family arrives with their desmopressin and demanded fluids for the patient who by now is in a terrible state and dangerously dehydrated.