Improved Insulin Resistance Post-Parathyroidectomy in Primary Hyperparathyroidism Patients with Prediabetes

In a study spanning 2016 to 2021, 231 patients underwent parathyroidectomy for primary hyperparathyroidism. Preoperatively, 32% had prediabetes, and 47% had insulin resistance. Twelve months postoperative, insulin resistance significantly decreased in both prediabetes (-0.69; p = .04) and insulin resistance groups (-0.85; p < .001). In prediabetes patients, 64% reduced insulin resistance, with 31% achieving fasting glucose normalization. Preoperative prediabetes or insulin resistance >2.5 independently predicted reduced insulin resistance, advocating for their consideration in surgery selection criteria.