Endocrine Abstracts

Recently, a position statement of a working group for renaming diabetes insipidus (DI) appeared in several renowned endocrine journals aiming to promote a change in the established name of DI. According to this position statement, the major arguments for renaming DI are: (a) it does not optimally reflect the underlying pathophysiology (b) it is often confused with diabetes mellitus (DM) leading to treatment errors and consequent adverse outcomes for patients. Although the above arguments sound reasonable there are still good reasons against changing the name of DI. Diabetes insipidus is a well-established medical term that has been in use for many years. The term “diabetes” runs deep in history and elegantly and accurately describes polyuria which is the hallmark symptom in all patients with DI. On the other hand, nowadays only a proportion of DM patients suffer from polyuria, while even more inappropriate is the use of terms like “pre-diabetes”. So, renaming DI and maintaining DM does not sound a choice which optimally reflects the underlying pathophysiology and clinical presentation of these disorders. What is true, for both health care providers and patients, is that the real need to change the name of a rare disease like DI, is its potential confusion with a very common disease like DM. However, is it certain that renaming DI will solve the existing problems? Owing to its rarity, DI is often neglected by health-care professionals, and increased awareness of this disease is urgently needed. In line with this, non-availability of desmopressin has been noticed in many emergency situations and obviously this is not going to be corrected by renaming DI. Also, a substantial proportion of patients with central DI suffer from additional anterior pituitary hormone deficits which if neglected are equally detrimental for the patients. So, renaming DI can only partly improve a situation for which the major challenge is to increase awareness and improve education and upskilling of healthcare workforce, to avoid serious untoward events during the emergency care of these rare patients. It should also be noticed that changing the name of DI would likely create problems with statistical reporting and library database searching, while the suggested use of both names for some years from now-on will add more complexity for both patients and non-aware healthcare providers. In conclusion, like for most rare diseases it may be more productive to focus on improving patient care and finding better ways of management, rather than changing its name.