Skin Problems Associated with Insulin Pumps and Sensors in Adults with Type 1 Diabetes: A Cross-Sectional Study

TY - JOUR

T1 - Skin Problems Associated with Insulin Pumps and Sensors in Adults with Type 1 Diabetes

T2 - A Cross-Sectional Study

AU - Berg, Anna Korsgaard

AU - Nørgaard, Kirsten

AU - Thyssen, Jacob P

AU - Zachariae, Claus

AU - Hommel, Eva

AU - Rytter, Karen

AU - Svensson, Jannet

PY - 2018/7

Y1 - 2018/7

N2 - BACKGROUND: In the future, widespread use of closed-loop infusion (artificial pancreas) systems to treat type 1 diabetes (T1D) may significantly improve glycemic control and enhance treatment flexibility. However, the infusion sets and plasters necessary for these treatments can cause dermatological complications that may hamper the spread of the new technology; few studies have investigated these complications in adults. The aim of this study was to describe the dermatological complications associated with continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) in adults.METHODS: A total of 118 adult patients from two different diabetes clinics completed a questionnaire concerning the dermatological complications associated with their CSII and/or CGM treatment, other treatment variables, duration of diabetes, allergies, skin care, and other pathologies.RESULTS: CGM or CSII use was associated with current eczema, scars, and wounds. In total, 34% of CSII users and 35% of CGM users currently had one or more skin lesions due to the use of these devices. We found no significant association with glycated hemoglobin (HbA1c) levels, a history of atopic dermatitis, or other skin pathologies. However, multivariate analysis revealed associations with a history of atopy and CSII-associated dermatological complications.CONCLUSIONS: Dermatological complications were present in one in every three patients and represent a significant challenge to using CSII and CGM to treat adults with T1D. Prospective studies on the causes of these complications will be required to develop preventive strategies and ensure that optimal diabetes treatment approaches that take advantage of the latest technology can be implemented.

AB - BACKGROUND: In the future, widespread use of closed-loop infusion (artificial pancreas) systems to treat type 1 diabetes (T1D) may significantly improve glycemic control and enhance treatment flexibility. However, the infusion sets and plasters necessary for these treatments can cause dermatological complications that may hamper the spread of the new technology; few studies have investigated these complications in adults. The aim of this study was to describe the dermatological complications associated with continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) in adults.METHODS: A total of 118 adult patients from two different diabetes clinics completed a questionnaire concerning the dermatological complications associated with their CSII and/or CGM treatment, other treatment variables, duration of diabetes, allergies, skin care, and other pathologies.RESULTS: CGM or CSII use was associated with current eczema, scars, and wounds. In total, 34% of CSII users and 35% of CGM users currently had one or more skin lesions due to the use of these devices. We found no significant association with glycated hemoglobin (HbA1c) levels, a history of atopic dermatitis, or other skin pathologies. However, multivariate analysis revealed associations with a history of atopy and CSII-associated dermatological complications.CONCLUSIONS: Dermatological complications were present in one in every three patients and represent a significant challenge to using CSII and CGM to treat adults with T1D. Prospective studies on the causes of these complications will be required to develop preventive strategies and ensure that optimal diabetes treatment approaches that take advantage of the latest technology can be implemented.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biosensing Techniques

KW - Blood Glucose/analysis

KW - Blood Glucose Self-Monitoring/instrumentation

KW - Cicatrix/etiology

KW - Cross-Sectional Studies

KW - Diabetes Mellitus, Type 1/blood

KW - Eczema/etiology

KW - Female

KW - Glycated Hemoglobin A/analysis

KW - Humans

KW - Hypoglycemic Agents/administration & dosage

KW - Insulin/administration & dosage

KW - Insulin Infusion Systems/adverse effects

KW - Male

KW - Middle Aged

KW - Pancreas, Artificial

KW - Surveys and Questionnaires

KW - Young Adult

U2 - 10.1089/dia.2018.0088

DO - 10.1089/dia.2018.0088

M3 - Journal article

C2 - 29893593

SN - 1520-9156

VL - 20

SP - 475

EP - 482

JO - Diabetes Technology & Therapeutics

JF - Diabetes Technology & Therapeutics

IS - 7

ER -