When should I consider referring a patient with diabetes insipidus to a specialist for further evaluation and management?

While specific referral criteria for diabetes insipidus are not explicitly detailed in the provided guidelines, referral to a specialist for further evaluation and management should be considered in the following situations:

• If an endocrine disease is suspected as the cause of persistent hyponatraemia, especially when no clear cause can be identified in primary care ¹. Diabetes insipidus is an endocrine condition that can affect fluid and electrolyte balance ¹.
• For children and young people with secondary bedwetting, consider referral to secondary care or an enuresis clinic if there are known or suspected physical or neurological problems, or if no underlying cause is identified ³,⁴,⁵. Diabetes insipidus, as a physical problem causing polyuria, could be an underlying cause in such cases ³,⁴,⁵.