Cutaneous adverse events (CAE) from FreeStyle Libre include allergic contact dermatitis (ACD) caused by the allergen isobornyl acrylate (IBOA). We aim to report CAE from this glucose sensor, ACD to IBOA in particular, and the outcome of using barrier films as a prevention. RESEARCH DESIGN AND METHODSA monocentric, retrospective review of medical files from adult and pediatric patients with diabetes using Freestyle Libre, in the period between December 2016 and April 2019, was performed with a focus on CAE. RESULTSFifty-seven of 1,036 patients with diabetes (5.5%) were referred to our dermatology department because of CAE from FreeStyle Libre. Thirty-nine of 1,036 (3.8%) had ACD due to IBOA. Only two patients, of whom one sensitized to IBOA, had a benefit from using barrier films. CONCLUSIONSCAE occurred in 5.5% of FreeStyle Libre users, and 3.8% suffered from ACD due to IBOA. Barrier films had limited value in the prevention.FreeStyle Libre (Abbott Diabetes Care, Witney, U.K.) is a sensor-based, flash-continuous glucose monitoring system applied on the skin for up to 14 days (1). However, it contains isobornyl acrylate (IBOA), a newly discovered allergen, which may cause allergic contact dermatitis (ACD) (2-5). We report a single-center experience of cutaneous adverse events (CAE) from this glucose sensor, including ACD due to IBOA, and the outcome of using barrier films as a prevention in these patients. RESEARCH DESIGN AND METHODSThe medical files of 614 adult and 422 pediatric patients with diabetes, using FreeStyle Libre in the period between December 2016 and April 2019, were retrospectively reviewed with a focus on CAE. In our center, patients are usually referred to the dermatology department for an allergy workup, including patch tests with IBOA 0.1% dispersed in petrolatum according to published guidelines (6). Whenever a barrier film (Cavilon No Sting Barrier Film) had been used to prevent the CAE ( 7), applied according to the manufacturers' recommendations, its impact on the CAE was verified.

Objectives Information on the efficacy of GH treatment in short SGA children starting their treatment in adolescence is limited. Therefore, adult height (AH), total height gain, and pubertal height gain were evaluated in short SGA children who started GH treatment at pubertal onset. Patient and Methods Growth data of 47 short SGA adolescents (22 boys) who started GH treatment at pubertal onset (PUB group) were compared with results from 27 short SGA patients (11 boys) who started GH therapy at least 1 year before pubertal onset (PrePUB group). Results The PUB group achieved a mean (±SD) total height gain of 0.8 ± 0.7 SDS and an AH of −2.5 ± 0.7 SDS after 4.1 ± 1.1 years of GH treatment with a dosage of 41.8 ± 8.4 μg/kg/day. These results were comparable with those in the PrePUB group, which was treated for a longer duration (5.8 ± 2.1 years), resulting in a total height gain of 1.1 ± 0.7 SDS and an AH of −2.1 ± 1.0 SDS. Multiple regression analysis showed a significantly lower height gain in pubertal patients, females, and patients weighing less at start of GH treatment. An AH above −2 SDS and above the parent-specific lower limit of height was, respectively, reached in 28% and 70% of PUB and 44% and 67% of PrePUB patients (NS). AH SDS was positively correlated with the height SDS at start of GH. Conclusions Short SGA adolescents starting GH therapy at an early pubertal stage have a modest and variable height gain. A normal AH can be expected in one third of the patients, especially in those with a smaller height deficit at onset of GH treatment.

Micro-albuminuria is considered an early clinical sign of diabetes nephropathy, however, early decrease of glomerular filtration can be present years before the presence of microalbuminuria. In this study, we explored whether urinary epidermal growth factor (uEGF) might serve as an early marker of diabetes nephropathy compared to microalbuminuria in children and adolescents. Methods: Children with type 1 diabetes mellitus (n = 158) and healthy controls (n = 40) were included in this study. Serum and urine samples were collected three times with an interval of at least one month to determine creatinine (serum and urine), epidermal growth factor and albumin (urine). Demographic data and routine lab values were extracted out of the electronic patient files. Results: uEGF was significantly lower in children with T1DM compared to healthy controls (p = 0.032). A relatively lower glomerular filtration rate (eGFR) was associated with a decreased uEGF (p < 0.001). uEGF was independently associated with eGFR in a multivariate analysis. Conclusion:This study provides evidence that uEGF can serve as an early marker of diabetes nephropathy in children and adolescents.

ConclusionThe present short‐term N‐balance study in adult PKU patients receiving a mixture of LNAA establishes a limited retention of nitrogen. Whether lysine could be the limiting amino acid remains to be determined by new short‐term N‐balance studies, with lysine added to the LNAA mixture. Therefore, special caution should be taken in the long‐term use in PKU patients of LNAA without any added lysine.