Summary
Endemic fluorosis is a condition resulting from prolonged ingestion of drinking water which contains excess fluoride. Studies on rats have suggested that fluoride toxicity may produce glucose intolerance and abnormalities in insulin secretion. We studied glucose and insulin profiles following an oral glucose load in patients with endemic fluorosis. Twenty-five young adults (age range, 15–30 years) with endemic fluorosis, and an equal number of matched healthy control subjects with normal fluoride intake were studied. Impaired glucose tolerance was demonstrated in 10 of 25 (40%) patients with endemic fluorosis. Patients with impaired glucose tolerance had significantly higher fasting serum immunoreactive insulin (p<0.05), higher fasting serum fluoride (p<0.001), and a significantly lower fasting glucose to insulin ratio than that in patients with normal glucose tolerance (p<0.001) or control subjects (p<0.05). The fasting serum fluoride levels correlated positively with the area under the glucose curve (r=0.80,p<0.01) in patients with impaired glucose tolerance. Interestingly these abnormalities could be reversed when the village was provided drinking water with fluoride levels within acceptable limits. The present study shows that chronic fluoride toxicity in humans could result in significant abnormalities in glucose tolerance which are reversible upon removal of the excess fluoride.
Article PDF
Similar content being viewed by others
References
Mangla B (1991) India: defluoridation battle. Lancet 337: 1213
World Health Organisation (1984) Enviroment Health Criteria-36. Fluorine and Fluoride. World Health Organisation, Geneva
Rigalli A, Ballina JC, Roveri E, Puche RC (1990) Inhibitory effect of fluoride on insulin secretion. Calcif Tissue Int 46: 333–338
Rigalli A, Ballina JC, Puche RC (1992) Bone mass increase and glucose tolerance in rats chronically treated with sodium fluoride. Bone Mineral 16: 101–108
World Health Organisation (1984) Guidelines for drinking water quality. Volume 1, recommendations. World Health Organisation, Geneva
Taylor JM, Scott JK, Maynard EA, Smith FA, Hodge HC (1961) Toxic effects of fluoride on rat kidneys. I. Acute injury from large single doses. Toxicol Appl Pharmacol 3: 278–289
Suketa Y, Asao Y, Kanamoto Y, Shakashita T, Okada S (1985) Changes in adrenal function as a possible mechanism for elevation of serum glucose by single large dose of fluoride. Toxicol Appl Pharmacol 80: 199–205
Suketa Y, Sato M (1980) Changes in glucose-6-phosphatase activity in liver and kidneys of rats treated with single large dose of fluoride. Toxicol Appl Pharmacol 52: 386–390
Howell SL, Montague W (1973) Adenylate cyclase activity in isolated rat islet of Langerhans: effect of agents which alter insulin secretion. Biophys Biochem Acta 320: 44–52
Caro JF (1991) Insulin resistance in obese and nonobese man. J Clin Endocrinol Metab 73: 691–695
Author information
Authors and Affiliations
Consortia
Rights and permissions
About this article
Cite this article
Trivedi, N., Mithal, A., Gupta, S.K. et al. Reversible impairment of glucose tolerance in patients with endemic fluorosis. Diabetologia 36, 826–828 (1993). https://doi.org/10.1007/BF00400357
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00400357