Binding of insulin to fibroblasts in lipoatrophic diabetes

Case summary

When skin biopsies were taken from our patient with lipoatrophic diabetes the young female was 22 years of age. She had a body weight of 30 kg, the body length was 163 cm. The first signs of lipodystrophy were seen in the third year of her life. About 4 years later the loss of subcutaneous fat was complete. The patient suffered from acanthosis nigricans when she was 11 years of age. At that time her case was described especially for its dermatological aspects (3). When at the age of 15 years the patient was admitted to our hospital diabetes mellitus with blood sugar levels about 400 mg/dl and excessive glucosuria had developed. Insulin did not influence the blood sugar levels but lowered the plasma levels of the ketone bodies (5). We could show a nearly normal response of the endogenous insulin production to an hypoglycemic stimulus. All known endocrine disorders which influence the action of insulin could be excluded. There were no elevated levels of insulin antibodies.

Control cultures of fibroblast were obtained from an 11 month old Puerto Rican girl-Institute for Medical Research, Camden, NY, Code GM 311-(Co 1), from a 14 years old white girl (Co 2), from a 24 years (Co 3) and 29 years old white man (Co 4). They all were of normal body weight and had no detectable metabolid disorder.