Physiol. Res. 52: 503-506, 2003


Does the Treatment of Primary Hyperaldosteronism Influence Glucose Tolerance? 


Third Department of Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic

Received March 13, 2002
Accepted September 6, 2002

Primary hyperaldosteronism (PH) is frequently considered to be a secondary form of diabetes mellitus (DM). In our previous study we attempted to evaluate the prevalence of DM among patients with PH compared to control subjects with essential hypertension (EH). We have noted a relatively high prevalence of DM and impaired glucose tolerance in PH, but the differences between the PH and EH groups did not reach statistical significance. We performed this study to assess whether the effective treatment of PH (surgical and conservative) would improve the glucose tolerance. We have studied 24 patients with PH of the following two subtypes: aldosterone-producing adenoma (APA) treated with adrenalectomy and idiopathic hyperaldosteronism (IHA) treated with spironolactone. No significant changes of glucose levels were found in the 60th and 120th min of the oral glucose tolerance test (OGTT) in the APA group. On the other hand, fasting glucose levels were decreased significantly after adrenalectomy. Plasma glucose levels were significantly increased in the 60th min, but no differences were found in fasting values and in the 120th min in the IHA group. There was a significantly higher incidence of impaired glucose tolerance (36 % before, 45 % after treatment) and DM (9 %, 18 %) in the IHA group compared to the APA group (8 %, 32 %; DM 0 %, 0 %). In conclusion, the treatment of PH does not improve glucose tolerance. Mild worsening of glucose tolerance after treatment could be explained by an increase of the body mass index. These data, in accordance with our previous study, do not support the idea that PH is a secondary form of diabetes mellitus.

Key words
Primary hyperaldosteronism • Blood pressure • Impaired glucose tolerance

Reprint requests
MUDr. B. Štrauch, Third Department of Internal Medicine, First Faculty of Medicine, Charles University, U nemocnice 1, 128 08 Prague 2, Czech Republic e-mail:

© 2003 by the Institute of Physiology, Czech Academy of Sciences