Cutaneous Reactions to Continuous Glucose Monitoring and Continuous Subcutaneous Insulin Infusion Devices in Type 1 Diabetes

Abstract

Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are the standard of care for type 1 diabetes (T1D). There is little reported on skin complications related to these devices. This study documents cutaneous reactions to CGM and CSII devices in children and young adults with T1D. 121 subjects (3-25 years) with T1D and CGM and/or CSII use were recruited over a 3-month period from the Naomi Berrie Diabetes Center at Columbia University Medical Center. A 5-question survey was completed for each subject detailing demographic data and device-related skin problems. 60% of subjects reported skin problems related to CGM and/or CSII use. Terms most frequently used to describe their reactions were red, itchy, painful, and rash. Subjects who used both CGM and CSII were more likely to report skin problems than those who used only CSII (OR [2.9]; p=0.015; 95% CI [1.2, 6.7]). There were no associations between skin problems and age, sex, or race/ethnicity. 22% of subjects with an adverse skin event discontinued use of their device due to their skin problem. 7% were evaluated by a dermatologist. 81% used a range of products to treat their symptoms, with variable perceived clinical effects. Skin complications related to CSII or CGM devices are common, and may lead to interruption or discontinuation of treatment. Future studies to elucidate the causes are needed. Table 1Supplemental Products Used By Patients: Effects on Skin ProblemsProduct categoryPatients using products in category (n)Patients reporting clinical improvement (%)Patients reporting no change (%)Patients reporting clinical worsening (%)Patients reporting discordant effects (%)Adhesive barrier wipe2726% (7/27)48% (13/27)11% (3/27)15% (4/27)Transparent film dressing2733% (9/27)48% (13/27)11% (3/27)7% (2/27)Topical steroid2277% (17/22)18% (4/22)0% (0/22)5% (1/22)Adhesive bandage1315% (2/13)54% (7/13)23% (3/13)8% (1/13)Hydrocolloid adhesive pad1369% (9/13)15% (2/13)15% (2/13)0% (0/13)Topical antibiotic1182% (9/11)18% (2/11)0% (0/11)0% (0/11)Adhesive remover1050% (5/10)40% (4/10)10% (1/10)0% (0/10) Disclosure R.K. Severin: None. R. Gandica: None. L.E. Levin: None. D.V. Belsito: None. M.C. Garzon: None. K.M. Williams: None.