Friday, March 6, 2009

The dangerous condition your pediatrician most likely is not screening for...

www.DrWeigh.com

According to the CDC, there has been a 90% increase in new cases of diabetes over the past ten years.

Unbelievable. Even more disturbing is that most children and adults with 'prediabetes' don't even know it. I am constantly diagnosing patients with pre-diabetes and the first question they have is, "How come my pediatrician never mentioned it?" The answer is simple... I really don't know. I can often tell that a patient has pre-diabetes simply by looking at the back of their neck. Acanthosis nigricans, or a darkening of the skin behind the neck or in the armpits and other skin folds, is all you need to see to know that your child has pre-diabetes. Look at the examples below... These are fairly advanced stages of acanthosis nigricans. Your child's may be lighter than this so look carefully.


















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 my 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.

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