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[IP] Re: smudges

I believe that the "smudges" referred to in the article are ancanthosis 
nigricans, which looks exactly like a dirty neck, or ring-around-the-collar, 
except the ring is on your neck rather than your shirt.  

Ancanthosis Nigricans (AN) is a skin condition that causes a darkening and 
thickening of the skin about your neck and other body folds such as the 
armpits, groin area and underneath your breasts.  The elevated levels of 
insulin in your body stimulate the growth of skin in these areas and the 
resulting skin is darker skin.  

This is an issue for individuals with type 2 diabetes or those with insulin 
resistance syndrome, sometimes also referred to as Syndrome X.  Because of 
the rising incidence of type 2 diabetes in children, AN is an early warning 
sign of a potential problem.  Insulin levels are high due to an insulin 
resistance, and these high insulin levels are initially able to keep glucose 
levels normal, often for years, before beta cell failure due to glucose 
toxicity occurs and diabetes is diagnosis.  

For those of you interested, other indicators insulin resistance syndrome or 
Syndrome X include:

Polycystic Ovary Syndrome (PCOS), a condition that appears to be caused by 
the high levels of insulin as well.  PCOS is characterized by infertility, no 
menstrual periods and obesity.  Just as with ancanthosis nigricans, it is 
caused by the elevated insulin levels stimulating a portion of the ovaries to 
overproduce male hormones, which throws off the menstrual cycle, in addition 
to causing acne and increased hair growth. 

Central Obesity means fat around the abdomen instead of obesity associated 
with an increase in size of your buttocks and thighs.  This obesity more 
commonly occurs in men and in postmenopausal women. 

High Blood Pressure is caused by the increased levels of circulating insulin 
as well.  It is estimated that Syndrome X is responsible for the high blood 
pressure in one-half of all large-sized people.

Dislipidemia means high levels of triglycerides, low levels of HDL 
cholesterol and the presence of small, dense LDL cholesterol molecules. 

Heart Attacks and Angina is caused by Syndrome X in over one-half of all 
patients seen in the hospital setting.

Family History of Type 2 Diabetes occurs in the majority of people who have 
Syndrome X.  There may also be a family history of coronary artery disease as 

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