RT Book, Section A1 McConkey, Stacy A1 Fals, Angela M. A2 Usatine, Richard P. A2 Sabella, Camille A2 Smith, Mindy Ann A2 Mayeaux, E.J. A2 Chumley, Heidi S. A2 Appachi, Elumalai SR Print(0) ID 1114879340 T1 Obesity T2 The Color Atlas of Pediatrics YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 978-0-07-176701-9 LK accesspediatrics.mhmedical.com/content.aspx?aid=1114879340 RD 2024/11/13 AB A 13-year-old Hispanic female is brought to her pediatrician with various concerns, including that her neck always appearing dirty no matter how much she washes and scrubs it. The pediatrician notes that the child has acanthosis nigricans of the neck and axillae along with obesity (Figure 194-1). The mother is obese and admits to having type 2 diabetes. A diet history reveals that the mother cooks traditional Mexican cuisine and the daughter is very fond of tortillas. She also loves to eat pizza, french fries, and other fast food. The girl is a good student but does not like to exercise or play sports. The pediatrician is concerned that the girl may have insulin resistance or type 2 diabetes so she plans to send the patient for screening labs including hemoglobin A1c and fasting blood sugar. She also recommends a healthier diet with less calories and increased physical activity. A referral to a nutritionist is offered.