What laboratory test should be prioritized for a patient with acanthosis nigricans and obesity?

In the context of a patient with acanthosis nigricans and obesity, prioritizing the hemoglobin A1C test is particularly important due to the association between acanthosis nigricans and insulin resistance. Acanthosis nigricans is often a clinical marker of underlying metabolic issues, most notably type 2 diabetes mellitus and prediabetes, conditions that can occur more frequently in individuals who are obese.

The hemoglobin A1C test measures average blood glucose levels over the past two to three months and is a crucial tool for diagnosing and managing diabetes. By evaluating the hemoglobin A1C, healthcare providers can assess the patient’s long-term glycemic control and determine if they are at risk for diabetes, which is often indicated by elevated A1C levels in this population.

While fasting blood glucose is also relevant for evaluating diabetes and insulin resistance, hemoglobin A1C offers a broader picture of glycemic control over time, making it particularly useful in chronic condition management. Therefore, in the setting of acanthosis nigricans and obesity, the hemoglobin A1C test is the prioritized laboratory investigation to assess metabolic health and guide further interventions.

Serum electrolytes and hemograms, while they have their value in