Lipodystrophy: Something to consider in the diabetes clinic

Claire Adams, National Severe Insulin Resistance Service (NSIRS), Addenbrooke’s Hospital and Metabolic Research Laboratories, Wellcome Trust–Medical Research Council Institute of Metabolic Science (WT–MRC IMS), University of Cambridge; Lisa Gaff, NSIRS and Wolfson Diabetes Centre, Cambridge University Hospitals NHS Foundation Trust; and Audrey Melvin, NSIRS, Addenbrooke’s Hospital and WT–MRC IMS, University of Cambridge. Lipodystrophy refers to a spectrum of rare conditions characterised by a lack of functional fat in the absence of calorie restriction. Individuals with lipodystrophy are at risk of metabolic complications, such as severe insulin resistance, dyslipidaemia and non-alcoholic fatty liver disease. Although rare, it is most often diagnosed in the diabetes clinic, where patients present with complications of the condition. The focus of this article is to provide an overview of lipodystrophic syndromes and their presentations, and to discuss the management implications of this condition.