Research Article

Prevalence of glucose intolerance in primary hyperparathyroidism and the benefit of parathyroidectomy

  1. A. A. Khaleeli*,
  2. J. N. Johnson,
  3. W. H. Taylor

Article first published online: 16 MAY 2006

DOI: 10.1002/dmrr.637

Issue

Diabetes/Metabolism Research and Reviews

Diabetes/Metabolism Research and Reviews

Volume 23, Issue 1, pages 43–48, January 2007

Additional Information

How to Cite

Khaleeli, A. A., Johnson, J. N. and Taylor, W. H. (2007), Prevalence of glucose intolerance in primary hyperparathyroidism and the benefit of parathyroidectomy. Diabetes Metab. Res. Rev., 23: 43–48. doi: 10.1002/dmrr.637

Author Information

  1. Departments of Medicine and Surgery, Halton General Hospital, Runcorn, UK

*Departments of Medicine, Halton General Hospital, Hospital Way, Runcorn, Cheshire WA7 2DA, UK.

Publication History

  1. Issue published online: 28 DEC 2006
  2. Article first published online: 16 MAY 2006
  3. Manuscript Accepted: 28 JAN 2006
  4. Manuscript Revised: 22 DEC 2005
  5. Manuscript Received: 20 MAY 2005

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Keywords:

  • diabetes mellitus;
  • primary hyperparathyroidism;
  • parathyroidectomy;
  • glucose intolerance and oral glucose tolerance test

Abstract

Background

Increased prevalence of diabetes mellitus (DM) in primary hyperparathyroidism (PHPT) is established, but not glucose intolerance (GI), nor benefit from parathyroidectomy on GI. We determined these during management of a continuous series of patients with PHPT routinely followed after surgery.

Patients and methods

WHO criteria classified 75 g oral glucose tolerance tests (OGTT) in 51/54 consecutively proven PHPT patients, into normal glucose tolerance (NGT), DM, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG); GI was derived by adding those with DM and IGT/IFG. OGTT were repeated after parathyroidectomy (mean follow up 2.4 ± SD 1.6 years). Paired student t tests were used to compare fasting and 2-h plasma glucose (PG).

Results

At presentation 32/54 patients (59%) had NGT, 10 IGT/IFG (19%) and 12 type 2 DM (22%), nine newly diagnosed. Before parathyroidectomy 17/35 patients had NGT (49%), 18 GI (51%), 12 DM (34%) and 6 IGT/IFG (17%). Five out of six patients with IGT/IFG had NGT, one with NGT developed IGT. At completion 23 patients (66%) had NGT, 12 GI (34%), 4 IGT/IFG (11%) and 8 DM (23%). After parathyroidectomy fasting and 2-h. PG fell in 30/34 normocalcaemic patients not on hypoglycaemic agents, 5.6 ± 1.0 to 5.4 ± 0.8 mmol/l, 7.2 ± 3.0 to 6.3 ± 3.1 mmol/l (p < 0.05, p < 0.01).

Conclusions

  • 1.
    At presentation with PHPT, OGTT commonly identifies Type 2 DM and GI.
  • 2.
    After successful parathyroidectomy fasting and 2-h. PG fall significantly (p < 0.05, p < 0.01). DM and IGT/IFG often ameliorates to IGT or NGT, persistently.

Copyright © 2006 John Wiley & Sons, Ltd.

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