The Effect of Fenfluramine and Caloric Restriction on Carbohydrate Homeostasis in Patients with Lipodystrophy

In an attempt to differentiate the effect of fenfluramine hydrochloride from that of caloric restriction on carbohydrate tolerance in patients with lipodystrophy, parameters of carbohydrate homeostasis were studied in patients with lipodystrophy during periods offenfluramine treatment and during periods of caloric restriction. Although carbohydrate tolerance appeared to improve initially in one patient when treated with fenfluramine, this improvement did not persist. No beneficial influence of fenfluramine on carbohydrate tolerance could be identified in the other patients studied. By contrast, all patients demonstrated an improvement in carbohydrate tolerance in response to caloric restriction. These data suggest that caloric restriction improves carbohydrate tolerance in patients with lipodystrophy whereas fenfluramine, in the absence of caloric restriction, has no long-term beneficial effect.