My six year old daughter is overweight and just had laboratory work. Her blood sugars were normal, but her insulin was elevated to 63. The pediatrician has referred her to specialist in Birmingham, Alabama, but it’s going to be a few weeks. Is it possible she could be type 2 diabetes?

It sounds just like she is obese and insulin resistant by definition, with normal blood glucose and elevated insulin levels. If she also has acanthosis nigricans (dark, thick skin around the neck, armpits, groin areas), this would also be a sign of insulin resistance. All this suggests future high risks of early heart attack, stroke, other vascular disease, hypertension, hypercholesterolemia and predisposition to type 2 diabetes and some excess androgens (excess acne, polycystic ovaries, menstrual irregularities, excess body hair, early, etc.). Treatment is difficult to accomplish but easy to state: lose weight with fewer calories taken in and more activity to burn off the excess body fat. Sometimes, there are diabetes medications that will combat insulin resistance (i.e., metformin) that are also utilized, but what is terms life style changes: cutting calories and increasing energy expenditure is the main treatment requirement. This is also called metabolic syndrome, forme fruste type 2 diabetes, pre-diabetes and many other similar names.

SB