Erfolgreiche Insulintherapie bei lipatrophischem Diabetes

Abstract

Two and a half years after manifestation of treatment-refractory lipoatrophic diabetes a 16-year-old girl had blood-sugar levels of about 500 mg/dl and hypertriglyceridaemia with fasting levels of about 3000 mg/dl, while there was no increase in ketone bodies. All the clinical, histological and radiological findings were those of generalized fatty tissue atrophy. In addition, she had marked axillary and periorbital acanthosis nigricans. Main symptoms were fatigue, weakness and excessive appetite. Intravenous insulin of at first 1200 IU daily reduced blood-sugar levels to normal. A good metabolic state was maintained by intensive insulin treatment with four intramuscular injections daily. On a dosage of 600-700 IU daily the HbA1 value dropped from 16.7% to 7.8%, triglyceride concentration to 300-400 mg/dl. The symptoms also regressed with normalization of the metabolic state.

Dysregulation of insulin-like growth factors in a case of generalized acquired lipoatrophic diabetes mellitus (Lawrence Syndrome) connected with autoantibodies against adipocyte membranes

“…Dose-dependent effects of rhIGF-I in insulin resistant, diabetic patients have been described recently (Vestergaard et al,, 1997). Böhmer et al (1991) reported a case of a 16-yearold girl with severe lipatrophic diabetes. In this case, the very high blood-sugar levels could almost be normalized by four intramuscular injections of highly concentrated insulin, finally by administering a total daily dosis of 700 U (U-400 Insulin Hoechst/Germany).…”

Acquired generalized lipodystrophy type 2-lawrence syndrome: a rare case report

“…12 Insulin resistant Diabetes Mellitus shows severe fasting and postprandial hyperinsulinemia, impaired glucose tolerance, hypertriglyceridemia and sequelae chylomicronemia, pancreatitis, hyperlipidemia, low HDL cholesterol levels, low plasma Leptin levels. 13 Low fat diet should be recommended. 17 Fibrates are efficacious in lowering serum triglycerides levels, used alone or in combination with low-dose statins.…”