The world-wide incidence of diabetes mellitus is at least 1.5%, and is probably higher in the elderly. The incidence of hyperparathyroidism is about one per thousand per year. It is therefore hardly surprising that these two endocrine disorders can co-exist. Indeed, the relative paucity of reports of the combination is surprising. The inter-relationships between parathormone, ionized calcium levels and diabetes mellitus are complex. In both hypo- and hypercalcemia the insulin response to a glucose stimulus is impaired, as is also the peripheral utilization of glucose. We present a diabetic patient on chronic hemodialysis who required insulin. Following removal of a parathyroid adenoma, the diabetes was controlled without insulin. We suggest that parathormone itself, independent of ionized calcium levels, may contribute to the production of a diabetes-like state in patients with hyperparathyroidism.
|State||Published - 1981|