Partial and Total Lipodystrophy: Changes in Circulating Sugar, Free Fatty Acids, Insulin and Growth Hormone Following the Administration of Glucose and of Insulin

SUMMARY The effect of glucose or insulin administration in a group of five patients with partial lipodystrophy and three with total lipodystrophy was studied. In only one patient was the glucose tolerance curve abnormal. Mean fasting serum insulin, growth hormone, free fatty acids (FFA) and triglycerides were all significantly elevated. The serum insulin response to glucose was grossly elevated. Insulin resistance was present. The serum insulin was shown to be immunologically normal, Exogenous insulin disappeared at a normal rate from the circulation, suggesting that the elevated insulin levels in the fasting state and after glucose were due to hypersecretion. Serum growth hormone levels failed to suppress normally after glucose. Serum FFA fell after glucose or insulin administration. In one patient treated with propranolol unusual insulin responses to the administration of glucose were observed. A working hypothesis capable of explaining the metabolic changes in lipodystrophy is proposed.