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Pigmentation True pigmentation dark circles are the result of increased melanin within the epidermis or even the dermis of the skin around the eyes

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Glycemic category (normoglycemia, prediabetes or type 2 diabetes) was determined by investigators on the basis of available information (for example, medical records, concomitant medication, and blood glucose variables) and in accordance with American Diabetes Association criteria 30 , which for prediabetes includes fasting plasma glucose levels of 100 mg dl –1 (5.6 mmol l –1 ) to 125 mg dl –1 (6.9 mmol l –1 ) or HbA 1c levels of 5.7–6.4% (39–47 mmol l –1 ), and for type 2 diabetes includes fasting plasma glucose levels of ≥126 mg dl –1 (7.0 mmol l –1 ) or HbA 1c levels ≥6.5% (48 mmol l –1 )