Are some diabetic patients genetically predisposed to hyperparathyroidism? There is a link between thyroid disorders and DM. What about the risk of developing hyperparathyroidism in patients with DM?
There have been some controversial results but in several studies a positive correlation was found between hyperparathyroidism and glucose intolerance. Moreover in thyroidectomized patients in which parathyroid glands have been removed, was found and improvement in blood glucose levels. Conversely in some diabetic patients, hyperparathyroidism contributed to poor glycemic control.
One of the explanation for this correlation rises from the effect of Fibroblast growth factor 23 that is implicated in paratohormone secretion and also with insulin secretion. Calcium levels in beta cells form Langerhans islets are linked to the activity of Ca2+ channels and this exerts an effect over insulin secretion
The prevalence of diabetes in 1HPT is about 8% and the prevalence of 1HPT in diabetes about 1% both are close to 3 fold greater than would have been expected. Taylor W published a couple of papers on this (1991 and 2001) and several authors have followed up his work in recent years. The cause may be related to effects other than FGF23 , in particular PTH effects on kidney regulation of glucose metabolism.
Thank you very much Dr Fraser for your answer. It appears that there is some degree of correlation, or relationship between these two pathologies, and the mechanism seems to be a complex one. There is also some past evidence from studies by Bannon, Ilstrup et al 1987 who explored whether if parathyroidectomy in patients with primary hyperparathyroidism could improve glycemic control, but I needed to know if any significant studies have been undertaken to explore the link between secondary hyperparathyroidism and DM .
Thanks again,
Regards, Sidharta
