Dark Neck Patches in Kids: Hidden Warning Sign for Diabetes Risk

Parents may sometimes believe a dark ring around a child’s neck is dirt or a tan. However, these skin changes that appear as dark, velvety, slightly thickened patches in body folds are a classic sign of acanthosis nigricans (AN) (1^✔ ✔Trusted Source
Acanthosis Nigricans as a Clinical Predictor of Insulin Resistance in Obese Children

Go to source). In children who are overweight, AN is often linked to early insulin resistance (IR), a condition where the body does not respond properly to insulin. Over time, this can progress to prediabetes and type 2 diabetes.

Visible Skin Signs of Hidden Metabolic Trouble

Acanthosis nigricans appears most commonly on the back of the neck, underarms, and groin. While the skin change itself is not harmful, it signals a deeper metabolic concern. High insulin levels stimulate excess skin growth and pigment, making these patches darker and velvety. The rise in childhood obesity has made this warning sign more common in younger age groups.

Study Evidence Linking AN with Insulin Resistance

A study published in Pediatric Gastroenterology Hepatology Nutrition examined 74 obese children. Researchers compared those with acanthosis nigricans to those without and recorded fasting glucose, fasting insulin, body mass index, and calculated HOMA IR (Homeostatic Model Assessment of Insulin Resistance) .

HOMA-IR is a number calculated from a blood test to check how well the body uses insulin. A higher HOMA-IR value means the body is becoming resistant to insulin, which can increase the risk of diabetes.

Key Findings Included

• Fasting insulin levels were significantly higher in children with AN (mean 24.1 mU/L) than those without (mean 9.8 mU/L)
• HOMA IR levels were more than double in the AN group (mean 5.74 versus 2.14)
• The thicker and darker the patch, the higher the level of insulin resistance

The study concluded that AN is an important physical clue for clinicians to screen for insulin resistance and possible early metabolic syndrome in children.

Evidence Shows the Risk Can Be Reduced

A weight management study published in Pediatrics followed 57 obese children for one year. Only those who reduced their body mass index standard deviation score by at least 0.5 showed a significant improvement in insulin sensitivity and metabolic health outcomes (2^✔ ✔Trusted Source
Insulin Sensitivity Among Obese Children and Adolescents, According to Degree of Weight Loss

Go to source).

This demonstrates that lifestyle measures that achieve meaningful weight reduction can improve insulin resistance and may reduce the severity of AN over time.

What Should Parents Do

When AN is noticed in a child-

• A blood test for fasting glucose and insulin is recommended
• Lipid profile and liver function tests check for metabolic syndrome
• Monitoring BMI and waist circumference helps track risk
• Healthy eating with fruits, vegetables, whole grains, and lean proteins is essential
• At least 60 minutes of daily physical activity is strongly advised
• Proper sleep and reduced screen time also support insulin balance

Dermatological treatments are considered only after the internal metabolic cause has been addressed.

Final Takeaway

A dark ring on a child’s neck or underarms should not be ignored. It can be the skin’s early messaging system, revealing insulin resistance long before diabetes symptoms begin. Early recognition and simple healthy lifestyle steps can protect long-term health and markedly reduce the risk of type 2 diabetes in the future.

References:

1. Acanthosis Nigricans as a Clinical Predictor of Insulin Resistance in Obese Children - (https://pghn.org/DOIx.php?id=10.5223/pghn.2016.19.4.251)
2. Insulin Sensitivity Among Obese Children and Adolescents, According to Degree of Weight Loss Available to Purchase - (https://publications.aap.org/pediatrics/article-abstract/114/6/1569/67884/Insulin-Sensitivity-Among-Obese-Children-and?redirectedFrom=fulltext)

Source-Medindia