A newly described cutaneous reaction at sites of insulin pump use in a child with Type 1 diabetes

Pérez, Victòria Aurora Ferrer; Husain, Sameera; Magro, Cynthia M.; Strom, Mark A.; Williams, Kristen M.; Levin, Laura E.

doi:10.1111/pde.14438

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…Alternatively, zinc crystals bound to insulin molecules may cause neutrophilic chemotaxis, lysis of those neutrophils leading to enzyme release and further zinc dispersion, and increased chemotaxis in an inflammatory cycle [30,40]. Interestingly, the switch to MDI from CSII led to fewer reactions [30], which is a contradictory finding to those of lipodystrophies [24,25].…”

Section: Other Skin Manifestationsmentioning

confidence: 99%

“…Erosions, subcutaneous nodules, and a pink vascular papule were additionally present on the bilateral buttocks. Biopsy revealed a neutrophilic and granulomatous inflammation at insulin pump injection sites [30]. Switching from CSII to MDI reduced the development of these lesions [30].…”

Section: Other Skin Manifestationsmentioning

confidence: 99%

“…Biopsy revealed a neutrophilic and granulomatous inflammation at insulin pump injection sites [30]. Switching from CSII to MDI reduced the development of these lesions [30].…”

Section: Other Skin Manifestationsmentioning

confidence: 99%

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Cutaneous Adverse Effects from Diabetes Devices in Pediatric Patients with Type 1 Diabetes Mellitus: a Systematic Review (Preprint)

Podwojniak,

Flemming,

Tan

et al. 2024

Preprint

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BACKGROUND Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusions (CSII) are the current standard treatment devices for type 1 diabetes (T1D) management. With a high prevalence of T1D beginning in pediatrics and carrying into adulthood, insufficient glycemic control leads to poor patient outcomes. Dermatologic complications such as contact dermatitis, lipodystrophies, and inflammatory lesions are among those associated with CGM and CSII, which reduce glycemic control and patient compliance. OBJECTIVE This systematic review aims to explore the current literature surrounding dermatologic complications of CGM, CSII, and the impact on patient outcomes. METHODS A systematic review of the literature was carried out using PRISMA 2020 guidelines utilizing five online databases. Included articles were those containing primary data relevant to human subjects and adverse CGM and CSII devices in pediatric populations of which greater than 50% of the sample size were ages 0-21. Qualitative analysis was chosen due to the heterogeneity of outcomes. RESULTS Following the application of exclusion criteria, 25 studies were analyzed and discussed. The most common complication covered is contact dermatitis with 12 identified studies. 6 studies concern lipodystrophies, 4 cover nonspecific cutaneous changes, and the remaining 3 cover unique cutaneous findings such as granulomatous reactions and panniculitis. CONCLUSIONS The dermatologic complications of CGM and CSII pose a potential risk to long-term glycemic control in T1D, especially in young patients where skin lesions can lead to discontinuation. Increased manufacturer transparency is critical and further studies are needed to expand upon the current preventative measures such as device site rotation and steroid creams, which lack consistent effectiveness.

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Section: Other Skin Manifestationsmentioning

confidence: 99%

Section: Other Skin Manifestationsmentioning

confidence: 99%

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Cutaneous Adverse Effects from Diabetes Devices in Pediatric Patients with Type 1 Diabetes Mellitus: a Systematic Review (Preprint)

Podwojniak,

Flemming,

Tan

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Cutaneous Adverse Effects From Diabetes Devices in Pediatric Patients With Type 1 Diabetes Mellitus: Systematic Review

Podwojniak,

Flemming,

Tan

et al. 2024

JMIR Dermatol

View full text Add to dashboard Cite

Background: Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusions (CSII) are the current standard treatment devices for type 1 diabetes (T1D) management. With a high prevalence of T1D beginning in pediatrics and carrying into adulthood, insufficient glycemic control leads to poor patient outcomes. Dermatologic complications such as contact dermatitis, lipodystrophies, and inflammatory lesions are among those associated with CGM and CSII, which reduce glycemic control and patient compliance.Objective: This systematic review aims to explore the current literature surrounding dermatologic complications of CGM, CSII, and the impact on patient outcomes. Methods:A systematic review of the literature was carried out using PRISMA 2020 guidelines utilizing five online databases. Included articles were those containing primary data relevant to human subjects and adverse CGM and CSII devices in pediatric populations of which greater than 50% of the sample size were ages 0-21. Qualitative analysis was chosen due to the heterogeneity of outcomes.Results: Following the application of exclusion criteria, 25 studies were analyzed and discussed. The most common complication covered is contact dermatitis with 12 identified studies. 6 studies concern lipodystrophies, 4 cover nonspecific cutaneous changes, and the remaining 3 cover unique cutaneous findings such as granulomatous reactions and panniculitis. Conclusions:The dermatologic complications of CGM and CSII pose a potential risk to long-term glycemic control in T1D, especially in young patients where skin lesions can lead to discontinuation. Increased manufacturer transparency is critical and further studies are needed to expand upon the current preventative measures such as device site rotation and steroid creams, which lack consistent effectiveness.

show abstract

A newly described cutaneous reaction at sites of insulin pump use in a child with Type 1 diabetes

Cited by 2 publications

References 9 publications

Cutaneous Adverse Effects from Diabetes Devices in Pediatric Patients with Type 1 Diabetes Mellitus: a Systematic Review (Preprint)

Cutaneous Adverse Effects from Diabetes Devices in Pediatric Patients with Type 1 Diabetes Mellitus: a Systematic Review (Preprint)

Cutaneous Adverse Effects From Diabetes Devices in Pediatric Patients With Type 1 Diabetes Mellitus: Systematic Review

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