Unmasking of normocalcemic primary hyperparathyroidism after sodium-glucose cotransporter-2 inhibitor initiation

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a class of medications that cause secondary hyperparathyroidism.In patients with normocalcemic primary hyperparathyroidism, SGLT2 inhibitor' initiation can cause overt hyperparathyroidism and hypercalcemia.We propose obtaining a baseline parathyroid hormone level before starting a SGLT2 inhibitor in patients with calcium levels in the upper limit of normal especially if they are under vitamin D supplementation.