Metreleptin was administered for 19 ± 20 months (median 12, range 1–108) and was associated with lowering of A1c in aggregated lipodystrophy, in generalized and partial subgroups, and in all genetic subgroups for whom sufficient patients were reported, namely those with LMNA, PPARG, AGPAT2 and BSCL2 mutations (0.5 to 1.5% least square mean reduction) (Level 3 evidence, Supplementary Data 3, Fig. 2). The gene discussed is PPARG; the disease is lipodystrophy.