Hypoglycemia with hyperinsulinemia in a chronic hemodialysis patient following parathyroidectomy.

We report a chronic hemodialysis patient with severe hyperparathyroidism who developed hypoglycemia with inappropriate hyperinsulinemia following parathyroidectomy. An abrupt fall in parathyroid hormone level and administration of large amounts of calcitriol may have resulted in increased insulin release and enhanced tissue sensitivity to insulin producing sustained hypoglycemia in this patient.