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A skin condition may identify young patients at risk for developing type 2 diabetes

Children and young adults who develop a skin condition called acanthosis nigricans (AN) have double the risk of having type 2 diabetes, even after controlling for diabetes risk factors, age, and body mass index. This condition typically causes dark, thickened, velvety skin at the back of the neck, armpits, elbows, and knees. Individuals with this skin condition are likely to have other risk factors for type 2 diabetes, such as obesity and hypertension. The presence of AN can alert physicians to high-risk individuals who may need diabetes counseling, notes Robert L. Williams, M.D., M.P.H., of the University of New Mexico School of Medicine.

Dr. Williams and colleagues analyzed diabetes risk factors and prevalence of AN among children and adults aged 7 to 39 years, who were cared for at clinics in a Southwestern primary care practice-based research network. Diabetes risk factors were common among the 1,133 patients: 69 percent had a family history of the disease; 3 percent of children and 12 percent of adults suffered from hypertension; 43 percent of children and 73 percent of adults were overweight or obese; and 80 percent were members of ethnic minorities.

Nearly one-fifth of the children (17 percent) and one-fifth of adults (21 percent) studied had AN. Those with AN had double the rate of diabetes compared with those without AN, after controlling for age, body mass index, and number of type 2 diabetes risk factors. The more diabetes risk factors that were present, the higher the prevalence of AN.

Patients 7 to 19 years of age and those 20 to 39 years of age with more than two diabetes risk factors were over eight and four times, respectively, more likely to have AN. After detecting AN, study clinicians typically discussed lifestyle modification, such as diet and exercise, with patients to decrease their risk of developing type 2 diabetes.

The study was supported in part by the Agency for Healthcare Research and Quality (HS13496).

See "Acanthosis nigricans and diabetes risk factors: Prevalence in young persons seen in Southwestern U.S. primary care practices," by Alberta S. Kong, M.D., M.P.H., Dr. Williams, Melissa Smith, B.A., and others, in the May 2007 Annals of Family Medicine 5(3), pp. 202-208.

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