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PubMed1983

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.

Adult↗
PubMed1984

Delirium as the predominant manifestation of hyperparathyroidism: reversal after parathyroidectomy.

A 67-year-old woman who had primary hyperparathyroidism presented with delirium rather than dementia as the predominant psychologic manifestation. After surgical removal of a parathyroid adenoma, there was a dramatic improvement in mental status. Psychologic retesting at six weeks after discharge showed her to be well oriented to time, place, and person, with no impairment of cognitive capacity.

Adenoma↗