Early sign of pre-diabetes

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There is a little-known very obvious sign of pre-diabetes often seen in overweight children; it is called acanthosis nigricans. Acanthosis nigricans is a darkening and thickening of the skin found in skin folds and creases; it is most obvious in the back of the neck, just underneath the hairline.
Acanthosis nigricans is one of the first things that I look for when examining an overweight patient. Acanthosis nigricans is usually seen with conditions that increase insulin levels, such as type 2 diabetes or being overweight. High insulin levels can trigger activity in skin cells, resulting in this dark, thick, velvety skin. Acanthosis nigricans can also be caused by medicines such as human growth hormone and oral contraceptives (aka "the pill"). There is no specific treatment for acanthosis nigricans, although weight loss may decrease its appearance. I always check fasting glucose and insulin levels to make sure that the patient has not yet developed diabetes. Acanthosis nigricans is a sign that a patient's weight is starting to affect his/her health. It should be a wake-up call that weight loss is needed immediately to prevent the development of diabetes. If your child is overweight, be sure to check their neck and make sure that they do not have this sign of "hyperinsulinemia" (higher than normal insulin levels). The absence of acanthosis nigricans, however, does not mean that your child does not have pre-diabetes or diabetes. Any overweight child should have their fasting glucose and insulin levels checked as a precaution.