{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:43Z","timestamp":1784557063557,"version":"3.55.0"},"reference-count":20,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2018,4,11]],"date-time":"2018-04-11T00:00:00Z","timestamp":1523404800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/deed.en_GB"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,4,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>The combination of hyperosmolar hyperglycaemic state and central diabetes insipidus is unusual and poses unique diagnostic and therapeutic challenges for clinicians. In a patient with diabetes mellitus presenting with polyuria and polydipsia, poor glycaemic control is usually the first aetiology that is considered, and achieving glycaemic control remains the first course of action. However, severe hypernatraemia, hyperglycaemia and discordance between urine-specific gravity and urine osmolality suggest concurrent symptomatic diabetes insipidus. We report a rare case of concurrent manifestation of hyperosmolar hyperglycaemic state and central diabetes insipidus in a patient with a history of craniopharyngioma.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>In patients with diabetes mellitus presenting with polyuria and polydipsia, poor glycaemic control is usually the first aetiology to be considered.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>However, a history of craniopharyngioma, severe hypernatraemia, hyperglycaemia and discordance between urine-specific gravity and osmolality provide evidence of concurrent diabetes insipidus.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Therefore, if a patient with diabetes mellitus presents with severe hypernatraemia, hyperglycaemia, a low or low normal urinary-specific gravity and worsening polyuria despite correction of hyperglycaemia, concurrent diabetes insipidus should be sought.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-18-0029","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T11:00:38Z","timestamp":1523530838000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["One too many diabetes: the combination of hyperglycaemic hyperosmolar state and central diabetes insipidus"],"prefix":"10.1530","volume":"2018","author":[{"given":"Snezana","family":"Burmazovic","sequence":"first","affiliation":[{"name":"1Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Henzen","sequence":"additional","affiliation":[{"name":"2Department of Internal Medicine and Endocrinology, Lucerne Cantonal Hospital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Brander","sequence":"additional","affiliation":[{"name":"1Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Cioccari","sequence":"additional","affiliation":[{"name":"1Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland"},{"name":"3Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Prahran, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"ref71","first-page":"w14521","article-title":"A ten-year follow-up study of treatment outcome of craniopharyngiomas","volume":"148","year":"2018","journal-title":"Swiss Medical Weekly"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1186\/1756-0500-6-325","article-title":"An unusual case of central diabetes insipidus & hyperglycemic hyperosmolar state following cardiorespiratory arrest","volume":"6","year":"2013","journal-title":"BMC Research Notes"},{"key":"ref171","first-page":"w14521","article-title":"A ten-year follow-up study of treatment outcome of craniopharyngiomas","volume":"148","year":"2018","journal-title":"Swiss Medical Weekly"},{"key":"ref41","first-page":"00054","article-title":"Diabet\u0131c hyperosmolar nonketotic coma induced by central diabetes insipidus","volume":"2","year":"2015","journal-title":"Journal of Diabetes, Metabolic Disorders 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