RA. Ramamrutham and SA. Westphal (2000). Diabetic ketoacidosis in association with acanthosis nigricans. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 6(2), 159-61.

PubMed 11421534

[Abstract]
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.