Early symptoms of diabetes and insulin resistance in children: Watch out for dark, velvety patches on neck or underarms

Symptoms of diabetes in children: Dark patches on the neck, underarms or elbows could be early indicators of future diabetes risk, warn experts (Image: Pexels)

World Diabetes Day, marked on November 14 every year, urges people to pay closer attention to the subtle symptoms of diabetes their body is giving. For many youngsters, the earliest hint of metabolic trouble is the appearance of dark, velvety patches on the neck or underarms, gentle yet important signals of insulin resistance.

Doctors are now encouraging parents to pay attention to darkened patches on the neck, underarms or elbows. These marks could be early indicators of future diabetes risk. Many parents first assume these patches are simply dirt, tanning or sweat marks. But doctors stress that these dark, thickened areas, medically known as Acanthosis Nigricans (AN), often tell a lot about the child’s metabolism.

“It’s one of the earliest outward signs of insulin resistance in children and teenagers,” Dr Abhishek Kulkarni, Consultant – Paediatric Endocrinology, Narayana Health SRCC Children’s Hospital, Mumbai, tells Moneycontrol. “Parents usually think it’s a hygiene issue, but in reality, AN often points to underlying hormonal imbalance,” he adds.

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The condition, says Dr Kulkarni, typically shows up on the back of the neck, underarms, between the thighs or around joints. “The changes come slowly: the skin grows thicker, rougher, slightly itchy and gradually darker over months,” the expert says.

In most young patients, Acanthosis Nigricans is linked to obesity, insulin resistance and metabolic syndrome,  all causes of type 2 diabetes. “The science behind it is that the body produces insulin, but can’t use it effectively,” he says. As insulin levels rise in the bloodstream, they overstimulate skin cells, leading to darkened folds.

“If ignored, insulin resistance can progress to prediabetes or diabetes, along with long-term cardiovascular risks,” warns Dr Kulkarni. Rarely, AN may be linked to certain medicines or internal illnesses, but most cases in children are metabolic in origin.

Doctors usually spot the condition during a routine examination. Dr Kulkarni adds, “But once identified, the child will likely undergo additional tests to assess metabolic health.”

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The tests include:

• Blood sugar and fasting insulin levels
• Lipid profile and liver function tests
• Assessment of weight, BMI and waist circumference

These tests help determine whether lifestyle changes,or medical treatment, are required.

How to reverse diabetes

Dr Kulkarni further shares tips on how parents can help reverse the condition:

• Encourage balanced nutrition and weight management, focusing on whole foods and fewer processed snacks.
• Increase daily physical activity and limit screen time to reduce sedentary habits.
• Prioritise adequate sleep and stress reduction to support hormonal balance.
• Use topical creams or gentle exfoliators only after medical advice; skin treatment works best once insulin resistance is controlled.

“Acanthosis Nigricans is not a cosmetic issue, it is a metabolic signal,” emphasises Dr Kulkarni. With early detection and timely lifestyle correction, insulin resistance can be reversed and diabetes prevented.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.