Lack of Ketosis in Lipoatrophic Diabetes

Several metabolic studies wece performed on a thirty-year-old Japanese woman with lipoatrophic diabetes. The fasting serum levels of insulin were high, and the insulin response to glucose ingestion was subnormal. The serum growth hormone levels were normal.

Lipolytic and ketonemic stimuli such as starvation and epinephrine injection failed to increase the serum concentrations of nonesterified fatty acids (NEFA) and ketone bodies. The absence of ketonemia was attributable to the lack of substrate delivered from adipose tissue.