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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Black Discoloration Around The Neck?

My 13 yr old has a black ring around her neck, which I assumed meant she wasn t washing her neck well enough. I have now learned that this is a sign of type 2 diabetes. Can we control this with her diet and exercise or will she have to have medication?
Tue, 30 May 2017
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Diabetologist,  's  Response
Hello, Thanks for the query.
The condition described is called "acanthosis nigricans". This is a clear sign of developing Insulin resistance. A person with this sign is most likely to develop T2 DM.
It is possible to prevent or postpone T2 DM provided the person is in a pre-diabetic state. Following are the criteria to determine if one is having normal blood glucose or has diabetes :1) Normal : FBG : 70 to 110 mg, PPBG :2) Pre-dibetic state : FBG: 125 mg and above, PPBG : 141 to 199 mg & HbA1c% 5.9 to 6.4.
3) Diabetes :FBG : 126 mg and above, PPBG : 200 mg and above & HbA1c% : 6.5 and above.
If a person has blood glucose levels in the prediabetic state, then by exercise, diet control and maintenance of near normal weight progression to diabetes can be either prevented or postponed.
But if already diabetes has developed then there is no way of reducing it or reverting to normal level. It can only be controlled by appropriate treatment,
plus diet control and regular exercise. Since there is no mention about the
blood glucose levels it is difficult to give an opinion. The skin lesion (dark color) may slowly reduce once insulin resistance is reduced or diabetes is controlled.Thanks.
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What Causes Black Discoloration Around The Neck?

Hello, Thanks for the query. The condition described is called acanthosis nigricans . This is a clear sign of developing Insulin resistance. A person with this sign is most likely to develop T2 DM. It is possible to prevent or postpone T2 DM provided the person is in a pre-diabetic state. Following are the criteria to determine if one is having normal blood glucose or has diabetes :1) Normal : FBG : 70 to 110 mg, PPBG :2) Pre-dibetic state : FBG: 125 mg and above, PPBG : 141 to 199 mg & HbA1c% 5.9 to 6.4. 3) Diabetes :FBG : 126 mg and above, PPBG : 200 mg and above & HbA1c% : 6.5 and above. If a person has blood glucose levels in the prediabetic state, then by exercise, diet control and maintenance of near normal weight progression to diabetes can be either prevented or postponed. But if already diabetes has developed then there is no way of reducing it or reverting to normal level. It can only be controlled by appropriate treatment, plus diet control and regular exercise. Since there is no mention about the blood glucose levels it is difficult to give an opinion. The skin lesion (dark color) may slowly reduce once insulin resistance is reduced or diabetes is controlled.Thanks.