Cutaneous Adverse Drug Reactions to Antidiabetic Medications and Medical Devices Used in Management of Diabetes Mellitus

Abstract

Context: Approximately 537 million adults (20 - 79 years) worldwide suffer from diabetes, a number that is estimated to reach 643 million by 2030. With the rising prevalence of diabetes, pharmacological therapy has become a cornerstone for its management. The advent of newer devices and drug categories has led to a multitude of adverse drug reactions, with a significant portion being cutaneous side effects. Given that the majority of patients are on multiple other medications, such as oral hypoglycemic agents, antihypertensives, and drugs for coronary artery disease and dyslipidemia, establishing the specific cause of adverse reactions can be challenging. Since the major step in management depends on avoiding or regulating the dose of the culprit drug, it is crucial for the treating clinician to be aware of the common adverse drug reactions associated with these medications. Objective: The article aims to review the reported cutaneous adverse events of oral hypoglycemic agents, insulin, and newer devices in the management of diabetes mellitus. Evidence Acquisition: A PubMed search was conducted using the keywords 'diabetes,' 'cutaneous side effects,' 'insulin,' 'OHA,' 'sulfonylureas,' 'metformin,' and 'antidiabetic drugs.' Results: New adverse events for each category of drugs are continually being identified and reported. These adverse events range from mild rash/pruritus to severe, life-threatening allergies. Conclusions: The management of any adverse reaction includes identifying and avoiding the causative agent. However, with limited literature on the cutaneous side effects of antidiabetic therapeutics, and many being case reports, it can be difficult for clinicians to diagnose these reactions. Our article provides a concise review of the vast spectrum of cutaneous side effects that these drugs and devices can cause, along with diagnostic tests and management strategies.