The Influence of Hyperparathyroidism on Glucose Metabolism in Uremia*

Abstract

Glucose metabolism in a group of adolescents and young adults with uremia was studied using the hyperglycemic clamp technique. In 8 adolescent patients, the glucose metabolic rate correlated negatively with PTH [parathyroid hormone] levels and positively with the glomerular filtration rate. Six patients, 1 adolescent and 5 adults on regular hemodialysis with severe hyperparathyroidism, had low glucose metabolic rates and reduced insulin sensitivity compared to normal subjects. After parathyroidectomy, the glucose metabolic rate improved by 47%; plasma insulin concentrations during hyperglycemia increased by 37%. Insulin sensitivity did not change significantly. Correction of hyperparathyroidism was associated with normalization of glucose metabolic rates and increased insulin secretion, but insulin resistance did not change.