Diabetes mellitus, glucose tolerance and insulin response to glucose in patients with primary hyperparathyroidism before and after parathyroidectomy.
In a retrospectively analyzed series of 441 patients operated for primary hyperparathyroidism (HPT), the prevalence of diabetes mellitus was 8.2%, which was three times higher than in the unselected age-matched population. Following parathyroid surgery, the need for antidiabetic treatment was unchanged. The insulin response to an intravenous glucose load was enhanced preoperatively [95 mU/1 +/- 41 (SD)] in twenty-six prospectively studied patients compared to postoperative (65 +/- 41 mU/1) investigations (P less than 0.01). This response was inversely correlated (r = 2, P less than 0.01) to the serum phosphate concentrations but not related to calcium or parathyroid hormone levels. Postoperatively, most HPT patients experienced a deterioration of their glucose tolerance (t 1/2 for i.v. glucose 54 +/- 12 and 64 +/- 21 min, respectively, P less than 0.05), and one-third of them had pathological values at follow-up. Despite this, neither the fasting blood glucose levels nor the values for haemoglobin A1c were significantly affected.
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000628:therapy; D005260:Female; D005947:Glucose; D005951:Glucose Tolerance Test; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000601:surgery*; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies
D001786:Blood Glucose; D007328:Insulin; D005947:Glucose