My 13 year old daughter with diabetes was diagnosed with acanthosis nigricans under her arms and a slight amount of discoloration on her neck. She has had type 1 diabetes since she was six years old. Will you please explain the relationship between type 1 diabetes and acanthosis nigricans? Is this skin disorder related to insulin?

It would be very unusual, indeed, for Acanthosis Nigricans to be associated with autoimmune diabetes. The first question that arises is whether that diagnosis was correct. Six years ago, it is possible that she did not have an antibody test, which, if positive, would have confirmed the diagnosis of Type�1A diabetes. Now, of course, it would be too late to do it.

This skin condition is not always associated with some form of diabetes, but, in your daughter’s case, it would most likely to be linked to one of the many syndromes of insulin resistance. It would be relevant to know, for instance, if she was overweight, had any evidence of a raised blood pressure, whether there was a close family history of a similar problem and whether she seemed to have any evidence of increased muscularity. A C-peptide level that is elevated at this stage would strongly favour a diagnosis such as type A insulin resistance. You will need to discuss these possibilities with her doctor and perhaps ask for a specialist opinion.

DOB