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.