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From San Bernardino, California, USA:

My 14 year old daughter has had Type 1 diabetes for 10 years. She's 5 foot, 5 inches, 170 pounds and gets 22 R and 82 N daily. A year or so ago, I noticed her neck area in the back was getting very dark. I thought it was from a chain but soon realized it was her pigment getting dark. I hear that this is a trait of Type 2 diabetes and is caused from insulin resistance. Her doctor is not concerned once she did a lot of testing and found her okay. But, I'd like to know if there is something I could be dong to get rid of this. Her blood sugar levels run on the high side because she can't control her appetite and she sometimes eats more than she should. What do you suggest?


First of all, I would suggest your daughter try to clean the dark area on her neck with an alcohol wipe. I've seen dark areas in the neck region which do not wash off with soap, but which do come clean with vigorous cleaning with alcohol (this is unrelated to diabetes).

If your daughter has had diabetes since the age of 4, most likely she has true insulin dependent diabetes. The pigmented skin condition you describe which is associated with Type 2 diabetes and insulin resistance is called acanthosis nigricans (this does not wipe off with alcohol). It is very unlikely that your daughter has this rare syndrome.

It is not uncommon for individuals who are overweight (whether or not they have diabetes) to have a similar pigmentation of the skin in the neck, under the arms or in the skin called pseudoacanthosis nigricans. I think the main question with your daughter is whether she really needs such a large dose of insulin, or whether her appetite is so big because you keep increasing the insulin. This can set up a vicious cycle as you increase the dose, the appetite increases, the blood sugars increase, and you continue to increase the dose (and the person gains weight.)

The only way to sort this out is to work closely with your physician and dietitian.


Original posting 16 Mar 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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