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Re: [IP] Ring around neck

Someone wrote:
> I'd be looking for other better-known signs, like excessive thirst, peeing
> all the time and sweet breathe. If the parents are sticking their head in
> the sand, it won't changes the facts, but it might make for a memorable
> trip to the emergency room. What are the odds that you can prick her
> finger?

A dark ring around the neck could be acanthosis nigricans, which can be a
marker of Type 2. It could also just be a dirty neck!!!!

IF this child has Type 2, then the time to get her checked is NOW. Don't
wait for any of the above symptoms because a Type 2 may never get them.
Irreversible damage can be done to the body while the person in question is
totally asymptomatic.

A random fingerstick will NOT always identify Type 2, especially in the
early stages -- at that point, the BG is high at times but also normal or
even low at other times.

If there is suspicion of Type 2 (i.e. the child is obese, or a relative
developed Type 2 or MODY at an early age), then a glucose tolerance test
should be done.

If you present this idea to the parents in a gentle way -- like mentioning
the ring around the neck and saying you're concerned, and why don't they ask
their pediatrician on the next visit, then possibly they will do something.
They may be unaware that this can be a sign of Type 2. And if they say it's
just a dirty neck, ask them to see whether it can be cleaned -- parents have
been known to rub their childrens' necks RAW trying to remove what they
thought was dirt!!!!

Good luck to this child!

Natalie ._c-
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