Putting insulin resistance into context by dietary reversal of type 2 diabetes


It has long been assumed that type 2 diabetes is caused by the combined effects of insulin resistance and loss of pancreatic islet beta cells. Much therapeutic effort has been directed towards decreasing insulin resistance even though results have been generally disappointing. Now that type 2 diabetes can be understood as a simple reversible condition, its component parts can be examined during the period of return to normal glucose tolerance.

A case of Berardinelli-Seip syndrome presenting with cirrhosis

Berardinelli-Seip congenital lipodystrophy (BSCL) is a rare autosomal
recessive disorder of generalised lipoatrophy, characterised by the absence of
functioning adipocytes, with lipid being stored in muscles, the liver and the pancreas.
The usual presentation is in adulthood, with manifestations of insulin resistance,
hypertriglyceridaemia and liver steatosis. Cirrhosis as the first presentation of BSCL in
a young adult is rare. We describe a patient with BSCL presenting with cirrhosis. To the