Treatment of Sheehan Syndrome with Central Diabetes Insipidus and Polyuria

Clinical Scenario

Sheehan syndrome can be complicated by central diabetes insipidus (central DI), a condition characterised by persistent, dilute urine output (polyuria) resulting from insufficient antidiuretic hormone release by the posterior pituitary. This specific complication requires a targeted management approach.

Central Diabetes Insipidus in This Setting

Central (neurogenic) DI occurs when the secretion of ADH (also called vasopressin) by the posterior pituitary is insufficient to meet urine concentration requirements. In Sheehan syndrome, posterior pituitary involvement drives this deficit, producing clinically significant polyuria that must be addressed directly.

Treatment Direction

Management of central DI in this setting centers on desmopressin (DDAVP) therapy with individualized therapeutic schedules — the complete protocol details how timing and administration are tailored around each patient's daily activities and rest requirements.

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References

DOI: 10.1210/jc.2016-2118

Central (neurogenic) DI occurs when the secretion of ADH (also called vasopressin) by the posterior pituitary is insufficient to meet urine concentration requirements.

When administering DDAVP in DI, we suggest individualized therapeutic schedules.

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