Diabetic ketoacidosis in association with acanthosis nigricans.
OBJECTIVE
To report the occurrence of diabetic ketoacidosis in three patients with acanthosis nigricans.


METHODS
Case reports with clinical and laboratory data are presented, and the syndrome of acanthosis nigricans is discussed.


RESULTS
Three obese male patients--two American Indians and one Polynesian man--sought medical attention because of symptoms of diabetic ketoacidosis and were noted to have acanthosis nigricans. No factor was identified that could have precipitated the diabetic ketoacidosis, which was resolved by treatment with insulin.


CONCLUSIONS
The unexpected association of diabetic ketoacidosis and acanthosis nigricans is documented in these three cases. The hyperinsulinemia associated with acanthosis nigricans results from insulin resistance, and when insulin resistance occurs in combination with impaired insulin secretion, diabetic ketoacidosis can result.
Ramamrutham
R A
RA
Department of Medicine, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85008, USA.
Westphal
S A
SA
D000052:Acanthosis Nigricans / Q000150:complications*; D000293:Adolescent; D000328:Adult; D044466:Asian People; D016883:Diabetic Ketoacidosis / Q000150:complications*; D005440:Fluid Therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007198:Indians, North American; D007328:Insulin / Q000627:therapeutic use; D008297:Male
D007004:Hypoglycemic Agents; D007328:Insulin