Can you have diabetes and/or Insulin Resistance and not have Acanthosis Nigricans?

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My knuckles and elbows have dark patches. Not my neck or armpits.

Blood Glucose 84

A1c 4,9

But maybe my insulin is huge and I have such good numbers. This will lead to diabetes ? I am thin, no alcohol, no smoking no diabetes history but I am losing weight unintentionally. Started increasing calories dramatically and I started losing weight faster.

Now what ?

My doctor said that if my insulin is high we can do nothing about it. We just wait for diabetes to come. If he gave me drugs to lower the already normal blood glucose it would be dangerous.

So I know from now that I will have DiAbetes ? Scary

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7 Replies

  • Posted

    I have got diabetes and definitely not  got acnthosis Nigricans and neither have any of my friends with diabetes. The reverse is also true - you can have acanthus nigricans and definitely not hav diabetes - there are other causes such as polycyclic ovary disease. Please do not worry about diabetes -it does not sound as though you have any predisposing causes
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  • Posted

    Hi Canader,

    I agree wit gill70346 about not having acanthosis nigricans but being diabetic.  I know many people, from a diabetes support group that I attend, that have diabetes but do not have acantosis nigricans.

    Acanthosis nigricans can also come about due to other medical conditions apart from insulin resistance.

    I seriously suggest you find another doctor ... one who says that there's nothing that can be done for someone that produces too much insulin.  A good doctor would look at what's causing the high levels of insulin.

    The most common reason is called Reactive Hypoglycemia, which occurs when the pancreas overproduces insulin in response a sudden rise in blood sugar (glucose) levels... we get the glucose from the breakdown of carbohydrates during the digestive process.  The way to treat this is to eat smaller, but more frequent meals throughout the day ... usually 5 or 6 smaller meals is the recommended approach ... that contain a smaller proportion of carbohydrates, but a higher proportion of fat(s) and/or protein(s).  (Fats and proteins slow down the absorption of glucose into the bloodstream, so you shouldn't have a sudden 'spike' in blood glucose levels, which is what stimulates the pancreas to produce more insulin.)

    A MUCH RARER condition is called fasting hypoglycemia, which is often caused by an insulin-producing tumour [tumor, if you are, in fact, one of my American cousins].  This type of hypoglycemia MAY require surgery to put right.

    Unfortunately, it would need you doctor getting his finger out and requesting some testing to be carried out.  I'm not sure why he hasn't already had to attend for an insulin level test to find out whether you do actually produce more insulin than is the norm.

    I give your doctor credit for stating that if he were to give you drugs to lower your already 'normal' blood glucose levels it WOULD be dangerous.

    Have you actually asked your doctor what might be causing your knuckles and elbows have dark patches?

    Acanthosis nigricans normally appears firstly in the softer areas of skin, such as neck, under the breasts, under the armpits, in the groin, etc., though it CAN also affect the elbows, knuckles, soles of feet, lips, and palms of hands.  (Acanthosis nigricans tends to be darker and more velvety in appearance, in case that's what you're seeing on your elbows and knuckles.)

    Some forms of medication(s) can also cause acantosis nigricans to form ... things such as birth control pills, human growth hormones, thyroid medications, and some body building supplements.

    In rare cases, acanthosis nigricans can be caused by:

    > stomach cancer, or gastric adenocarcinoma

    > adrenal gland disorders, such as Addison’s disease

    > disorders of the pituitary gland

    > low levels of thyroid hormones

    > high doses of niacin

    I wish you well in finding out what it is that's actually wrong with you, Canader.

    Be well.

    Lots of Love and Light.

     Mick

    x x x x

     x x x

    P.S. Please don't be offended, or alarmed, at the 'x's'.  It's merely a logo, of sorts, that I've used for the past 40 years or so.

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    • Posted

      Thanks for giving adding much more detail to what I said. The key thing is that Canader's doctor needs to find out why she is producing too much insulin otherwise I think he is being negligent

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    • Posted

      Thank you micksmixxx. Your answer is fantastic. It covers so much.

      One year ago I had my thyroid surgically removed because of hypertyroidism. My knuckles and Elbows were dark even then ( like 10 years ago ). After surgery it took me around 8 months to stabilise the TSH, T4 T3 to really optimal levels and they stay there. Of course I need to take Levothyroxine for the rest of my life. 

      I don't know if it's the drug that I am taking that is causing acanthosis nigricans because I had this condition years before.

      Doctors like to guess your condition without running diagnostic tests. We don't live in the 1930's, that's so unbelievable. I will pay for these tests I don't care.

      I already booked an appointment with another doctor and I will try to talk him into testing the C-Peptide. I read online that is a good indicator of measuring the insulin level.

      I also booked an appointment with an endocrinologist because 3 weeks ago I had 12-h salivary cortisol test ( 7 samples) and it was high all day long, so it cannot be Addison's Disease.

      One thing that wort's a mention, two days ago I ate 3 chocolates in a row. This happens very very rarely but it happened anyway. I noticed my knuckles going totally black. After 6-7 hours they went back to normal "bruisy"-brown color. This must mean something. Something with insulin. I will find out, I know my body and will not leave it like that.

      My hyperthyroidism was left undiagnosed for years and many doctors wondered why my heart was beating so fast and hard. My mother actually mentioned it, that's why I went to test the hormones and she was right.

       

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    • Posted

      Hi gill70346,

      I agree with you, ma'am, that Canader's doctor DOES need to get his or her finger out and arrange for some testing to be carried out.

      Lots of Love and Light.

       Mick

      x x x x

       x x x

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    • Posted

      Dear Canader,

      Thank you for your response.

      I must admit, I was a little hesitant about pointing out what other conditions could cause acanthosis nigricans as SOME people ... and I am NOT pointing my finger at you ... would automatically look at the worst thing listed and assume that that's what might be wrong with themself.

      It's tragic, in this day and age, that SOME doctors are afraid to 'let on' that they don't know everything.  If your own doctor was unsure of what MIGHT have been te cause, he should have felt comfortable enough to have referred you on to another doctor who MAY have known.  It's really surprising tat so many doctors had wondered why your heart was beating so fast and hard, yet did nothing about it ... at least, until you'd received a diagnosis of hyperthyroidism.

      The C-Peptide test IS a good test for measuring how much insulin your pancreas is producing, Canader.  It is sometimes used to determine whether someone is a type 1 or a type 2 diabetic if there's any doubt as to which type a person might be suffering with.  (A type 1 diabetic would produce very little to no insulin at all, and a type 2 diabetic would produce more insulin than the 'normal' range ... this is because their body's cells have become resistant to the effects of te insulin that's being produced, meaning that more insulin would be required to have the same effect.  It's used for getting glucose (sugar) from the bloodstream into te body's cells, where it is used to create energy, thereby keeping us alive.)

      C-Peptide is a substance produced by the beta cells in the pancreas when proinsulin splits apart and forms one molecule of C-peptide and one molecule of insulin.

      I've just done a quick search to see if I can find a couple of pages with regards to the C-Peptide test, my friend, and found a couple ... both on the same website.

      https://labtestsonline.org/understanding/analytes/insulin/tab/test

      https://labtestsonline.org/understanding/analytes/c-peptide/tab/test

      I'm not sure whether this is the same site that you found your information about C-Peptide, but it's useful information in any case.

      I've just found another website with regards to acanthosis nigricans, my friend:

      http://www.webmd.com/skin-problems-and-treatments/acanthosis-nigricans-overview

      You MAY find it informative.

      It tickled me when you wrote "Doctors like to guess your condition without running diagnostic tests. We don't live in the 1930's, that's so unbelievable."  We have a different medical system over her in the UK, where the majority of care/treatments/testing/diagnosis, etc. is carried out under our NHS (National Health Service).  This is a system similar to what ex-President Obama tried to introduce in the United States, whereby the State would pay, or subsidise medical costs.  (Over here, patients don't pay for tests and treatments, or it's highly subsidised ... unless that person decides to go 'private', which is the way it works in North America, where all tests, treatments, procedures, etc. are paid for from the patient's own pocket.

      You are correct, Canader, in believing that if your cortisol level is high then it is HIGHLY UNLIKELY that Addison's disease could be a problem for you.  On saying that, salivary cortisol testing is NOT normally sufficient to give a definitive diagnosis, or rebuttal of a diagnosis of Addison's disease.  I know that wen I was tested for it I was having half hourly blood tests taken for 6 to 8 hours as a hospital in-patient.  (I don't have Addison's disease, but I do have Adrenal insufficiency, which requires that I take a cortisol supplement twice a day.)

      High levels of cortisol MAY be indicative of Cushing's Syndrome.  Again, further testing would likely be required before you would get any sort of acknowledgement that this may be a problem.

      I'm afraid I can't comment on whether the 3 chocolates would have affected acanthosis nigricans in the way you describe, my friend.  I would have though not, as acantosis nigricans tends to take years to develop and I've never known anyone experience anything so dramatic as you witnessed.

      If you're seeing an endocrinologist, s/he would be the best person to request a C-Peptide test from.  I say this as endocrinologists are specialists in hormones, glands, and hormonal disorders.  (Insulin is a hormone, if you weren't aware.)

      Sorry to have waffled on for so long, and I truly do hope that I haven't frigtened you in any way.  That truly is NOT what I was intending to do.

      Be well, Canader.

      Lots of Love and Light.

       Mick

      x x x x

       x x x

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  • Posted

    Thanks again for the answer. I will post the outcome of the visits here by the end of this month hoping to help some patients who have the same condition.
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