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Banning, F.; Rottenkolber, M.; Freibothe, I.; Seissler, J. and Lechner, A. (2017): Insulin secretory defect in familial partial lipodystrophy Type 2 and successful long-term treatment with a glucagon-like peptide 1 receptor agonist. In: Diabetic Medicine, Vol. 34, No. 12: pp. 1792-1794

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Abstract

Background Familial partial lipodystrophies are rare monogenic disorders that are often associated with diabetes. In such cases, it can be difficult to achieve glycaemic control. Case report We report a 34-year old woman with familial partial lipodystrophy type 2 (Dunnigan) and diabetes;her hyperglycaemia persisted despite metformin treatment. A combined intravenous glucose tolerance-euglycaemic clamp test showed severe insulin resistance, as expected, but also showed strongly diminished first-phase insulin secretion. After the latter finding, we added the glucagon-like peptide-1 receptor agonist liraglutide to the patient's treatment regimen, which rapidly normalized plasma glucose levels. HbA(1c) values <42 mmol/mol (6.0%) have now been maintained for over 4 years. Conclusion This case suggests that a glucagon-like peptide-1 receptor agonist may be a useful component of glucose-lowering therapy in individuals with familial partial lipodystrophy and diabetes mellitus.

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