National recommendations on lipodystrophy

Abstract

Lipodystrophies are rare disorders characterized by selective loss of adipose tissue, resulting in severe insulin resistance, diabetes mellitus, hypertriglyceridemia, hepatic steatosis, and a high risk of pancreatitis and cardiovascular disease. Delayed recognition remains one of the main determinants of adverse outcomes, making early clinical suspicion and timely diagnosis essential for improving patient care.

This update session highlights the major advances incorporated into the 2026 Argentine Recommendations for the Diagnosis and Management of Lipodystrophies, developed by a multidisciplinary expert panel of the Argentine Diabetes Society. Through representative clinical cases, the presentation will focus on the clinical features that should prompt suspicion of lipodystrophy, the role of clinical and genetic classification, and the practical diagnostic algorithm proposed by the consensus.

The session will summarize key recommendations for comprehensive follow-up, including systematic assessment of metabolic, hepatic, cardiovascular, renal, and endocrine complications. Emphasis will be placed on multidisciplinary care and individualized management according to the lipodystrophy subtype and each patient's metabolic profile.

Current therapeutic recommendations will also be reviewed, focusing on lifestyle intervention, nutritional management, treatment of diabetes and severe dyslipidemia, and the incorporation of emerging pharmacological therapies. The available evidence supporting GLP-1 receptor agonists, dual GIP/GLP-1 receptor agonists, SGLT2 inhibitors, and metreleptin will be discussed, together with their place within the proposed treatment algorithm and patient selection criteria.

The aim of this presentation is to provide practical, evidence-based guidance that facilitates earlier diagnosis, improves the management of metabolic complications, and supports the implementation of the 2026 Argentine recommendations in everyday clinical practice.