Successful pregnancy in a woman with lipoatrophic diabetes mellitus. A case report.
BACKGROUND: Lipoatrophic diabetes mellitus is a rare insulin-resistance syndrome. A successful pregnancy occurred in a woman with lipoatrophic diabetes with no antepartum or intrapartum complications except hypertriglyceridemia, treated with gemfibrozil. CASE: A 29-year-old primigravida had lipoatrophic diabetes most consistent with congenital partial lipodystrophy (Kobberling-Dunnigan syndrome). The antenatal course was remarkable only for a midtrimester rise in serum triglycerides. The patient underwent oxytocin induction and an uncomplicated vaginal delivery. CONCLUSION: This case demonstrates that women with lipoatrophic diabetes who are otherwise healthy should not be discouraged from trying to conceive. Blood lipids should be checked periodically and hypertriglyceridemia treated to prevent pancreatitis. Gemfibrozil was used in this patient without apparent adverse effects.