Remission of non-insulin-dependent diabetes mellitus following resection of a parathyroid adenoma.
A 56-year-old woman presented with diabetes mellitus and primary hyperparathyroidism simultaneously. Initial random blood glucose was recorded at 20.8 mmol l-1, serum calcium was 3.07 mmol l-1 (normal range 2.10-2.55 mmol l-1), and plasma parathyroid hormone estimation by intact assay was 110 ng l-1 (normal range 10-65 ng l-1). Initial glycated haemoglobin was 9.4% (non-diabetic range < 7.5%). Left lower parathyroidectomy was carried out and pathology confirmed the presence of a chief cell adenoma. The gland measured 10 x 5 x 5 mm. Following parathyroidectomy serum calcium normalized, glucose tolerance improved, and a subsequent 75 g oral glucose tolerance test was normal. The patient weighted 80 kg at presentation but the post-operative weight had risen to 81.5 kg. The most recent glycated haemoglobin was 4.6%. Primary hyperparathyroidism may have a reversible effect on glucose tolerance.
Quin
J D
JD
Department of Medicine, Royal Sussex County Hospital, Brighton, UK.
Gumpert
J R
JR
D000236:Adenoma / Q000150:complications / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000601:surgery; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications / Q000601:surgery*; D016105:Parathyroidectomy; D012074:Remission Induction