I have a eight year old daughter who weighs 159 pounds. She continues to gain weight. I am told, over and over, that her body produces too much insulin for her. I was told that there is nothing that can be done for her. Everything she eats turns into fat because of the high insulin levels in her body. I was told that I just needed to watch what she is eating, and wait for her pancreas to shut down. When this happens, then and only then, can the physicians assist in this problem. She has a black ring around her neck which never goes away. I understand this is from the insulin which is building in her body. I am very concerned and need to know where to turn. I was told that by the time her pancreas shuts down she will then have type 2 diabetes. This concerns me. Please let me know if you have any answers to these questions. I am losing all hope of any type of solution for my child.

As I read your daughter’s story, I wondered if perhaps you had misinterpreted what her doctor told you. You don’t tell us what her blood insulin levels were or whether her blood sugar or urine sugar levels have been measured. The presence of obesity with the dark ring on the neck, which is almost certainly Acanthosis Nigricans , suggests some form of insulin resistance as the basic problem rather than hyperinsulinism. Obesity itself can bring this about. Your daughter may be in the earliest stages of Type�2 diabetes, a diagnosis which is increasingly being made in children, and which is significantly more common in girls that in boys.

My suggestions would be to test her urine occasionally for glucose using a simple dipstick test and every six months or so to arrange a fasting blood sugar test which should be below 125 mg/dl [7.0 mmol/l]. It would be helpful to know what an actual fasting blood level of insulin was, and I would expect it to be normal or only slightly increased. Whether or not though the insulin resistance is due to type 2 or to obesity alone, it is treating the body weight that is the greatest problem. It is easy to prescribe diet and exercise, but the results are very discouraging and surgery which would be considered in adult is not appropriate for children. You might ask you doctor though about a drug called sibutrimine which is beginning to be used in children for this problem.

DOB