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Friday, November 28, 2014

Lipodystrophy Diabetes

What is lipodystrophy?


Under lipodystrophy refers to a change in the subcutaneous fatty tissue, which can be localized or generalized form. The changes may be reversible depending on the cause.

Forms of lipodystrophy


Lipohypertrophy under insulin therapy
With frequent and repeated injection of insulin to a very limited area of skin it comes through the lipogenetic effect to an increase of adipose tissue. The result is a poorer absorption of insulin, and in addition, a metabolic degradation. Recessing the injection site leading to a complete recovery.

Lipodystrophy syndrome during antiretroviral therapy
The lipodystrophy is a metabolic syndrome that can occur in HIV-infected patients receiving antiretroviral therapy. Older studies suggest an appearance at 30-50% standing under HAART patients. However, studies on current treatment regimes show a significantly lower occurrence, as in the first-line annual incidence of 5-10% is reported that seems to proceed in the following years less. The lipodystrophy is associated with an increase in blood lipids and serum cholesterol as well as a redistribution of adipose tissue, with both atrophic and hypertrophic changes may occur. Sufferers typically develop Fettauszehrungen in the facial area (lipoatrophy), and on the extremities; the other hand, often creates a "buffalo hump" and a larger fat deposits in the abdominal area ("spare tire"). In addition, there is a resistance to insulin. The lipodystrophy affecting the infected cosmetically strong and increases in yet unknown extent the risk of HIV-infected individuals developing diabetes or cardiovascular disease.

Familial lipodystrophy syndromes
There are two very infrequent genetic diseases. In type I or Köbberling lipodystrophy syndrome which affects the lower half of the body, while type II or Dunningan syndrome lipodystrophy also affects the trunk. In addition, there is a proliferation of adipose tissue on the face and neck, resulting in those affected to a pseudo-cushingoiden appearance. Among those affected, typically young women after puberty, there is a hirsutism, the women look muscular due to lack of subcutaneous fat and thus protruding muscles and blood vessels. But in fact the body is suffering from a pathological, but visceral fat accumulation and located a massive hypertriglyceridemia, can this lead to acute pancreatitis and via increased insulin resistance to diabetes mellitus. The therapy consists of the administration of recombinant leptin.

There is also the innate Congenital generalized lipodystrophy with other abnormalities.

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