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September 29, 2003

Diagnosis and Symptoms

Question from Savage, Minnesota, USA:

My nine year old daughter has a skin condition that her pediatrician identified last fall as acanthosis nigricans. She is not overweight (actually quite thin), but does have some family history of diabetes. That, along with her ethnic background, are risk factors for type 2 diabetes. Her doctor considered it, but did not recommend any testing at that time and seems to be less concerned because she is not overweight. With what I've read, however, I'm more concerned with the fact that she has this when she isn't overweight, and we can't try weight loss as an intervention to prevent the development of type 2 diabetes. I'd appreciate your opinions on this.

Answer:

Acanthosis Nigricans is a skin condition that is linked to a heterogeneous group of genetic conditions that are characterized by insulin resistance. By far the most common of these, of course, is type 2 diabetes. Being of normal weight does not guarantee that she will never develop this form of diabetes, and I agree with the doctor that additional testing beyond an occasional fasting blood sugar, does not seem necessary at the present. At the same time, I would think it important to keep emphasizing exercise and the avoidance of junk food because being overweight can contribute to insulin resistance.

DOB
Additional comments from Dr. Larry Deeb:

I would regard it as a risk factor, watch it and try to avoid weight gain. Otherwise, I don’t have any specific prevention for diabetes. For type 2, the Diabetes Prevention Program (DPP) trial was diet and exercise.

LD