Allergic contact dermatitis caused by isobornyl acrylate in OmniPod, an innovative tubeless insulin pump

Raison‐Peyron, Nadia; Mowitz, Martin; Bonardel, N.; Aerts, Olivier; Bruze, Magnus

doi:10.1111/cod.12995

Cited by 79 publications

(91 citation statements)

References 8 publications

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“…Although our GC‐MS method is not optimal for analysis of colophonium‐related substances, the presence of methyl dehydroabietate (indicated from library spectra) in the extracts was likely, which indicates the use of colophonium in the device. However, the other four patients were sensitized to the allergen IBOA, an allergen that was the culprit allergen in the FreeStyle Libre glucose sensor and also in the insulin patch pump Omnipod, and now also detected by GC‐MS analysis in the Enlite glucose sensor, and likely also in the Paradigm infusion sets. It should be noted that IBOA was also detected in insulin pump infusion sets in 1995 .…”

Section: Discussionmentioning

confidence: 99%

“…However, the other four patients were sensitized to the allergen IBOA, an allergen that was the culprit allergen in the FreeStyle Libre glucose sensor and also in the insulin patch pump Omnipod, and now also detected by GC‐MS analysis in the Enlite glucose sensor, and likely also in the Paradigm infusion sets. It should be noted that IBOA was also detected in insulin pump infusion sets in 1995 . Our analyses demonstrated the presence of IBOA in the extracts of the Enlite sensors (with the adhesive patches removed) but not in the extracts of the adhesive patches.…”

Section: Discussionmentioning

confidence: 99%

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Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

et al. 2019

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Background: The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) in this sensor has been identified as one of the culprit allergens.Objectives: To report on the presence of IBOA in devices produced by Medtronic, namely, the Enlite sensor and the insulin infusion set Paradigm MiniMed Quick-set. Patients and Methods: Five patients reacting to the glucose sensor Enlite and/or the insulin infusion set Paradigm MiniMed Quick-set observed in three clinics (two Belgian and one Swedish) were patch tested with the baseline and other series, as well as with IBOA; four of them also with pieces of adhesive patches from the devices, and two with a thin layer chromatogram of Enlite glucose sensor extracts. Gas chromatography-mass spectrometry (GC-MS) analyses were performed.Results: Four patients reacted to IBOA and one to colophonium, a known allergen in Enlite, and three to the adhesive part of the sensor or the insulin infusion set. IBOA was identified in the sensor by GC-MS, and its presence was indicated in the infusion set.Conclusions: IBOA is a contact allergen in Enlite glucose sensor, and likely also in the infusion set. Therefore, these devices are not suitable alternatives for patients sensitized to the FreeStyle Libre sensor.acrylates, allergic contact dermatitis, delayed hypersensitivity, glucose sensor, insulin pump, isobornyl acrylate, medical device

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

et al. 2019

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“…Isobornyl acrylate (IBOA) (CAS no. 5888‐33‐5) has recently been identified as the major culprit allergen in diabetic patients sensitized to the glucose sensor Freestyle Libre (Abbott Diabetes Care, Witney, UK) and similar medical devices . As previously reported, numerous patients allergic to Freestyle Libre also reacted positively to sesquiterpene lactone (SL) mix (SLM) (Chemotechnique Diagnostics, Vellinge, Sweden), which is included in the baseline series, and contains equimolar concentrations of alantolactone (0.033%; CAS no.…”

Section: Introductionmentioning

confidence: 96%

Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre

et al. 2019

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Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate (IBOA), with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone (SL) mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations for this association. Patients and Methods: Fifty-three Freestyle Libre-allergic patients were patch tested with IBOA and/or SLM, and several were also patch tested with the components of SLM. Chromatographic analyses were performed on the glucose sensor, IBOA, and the components of SLM. Results: Thirty-three patients reacted positively to the components of SLM, and 11 of 27 patients reacted positively to alantolactone, in particular. Gas chromatography-mass spectrometry (GC-MS) analyses did not detect these chemicals in the different parts of the glucose sensor, or in IBOA. Conclusion: Significant co-sensitizations between SLs on the one hand and the glucose sensor FreeStyle Libre and/or isobornyl acrylate on the other hand exist, without evidence of the presence of SLs via GC-MS analysis. Cross-reactions between them seem improbable. As a possible hypothesis, a common precursor for both, such as camphene, may exist. K E Y W O R D S allergic contact dermatitis, chemical analysis, diabetes mellitus, FreeStyle Libre, GC-MS, glucose sensor, isobornyl acrylate, medical device, sesquiterpene lactones, simultaneous reactions

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“…IBOA may play a role as a hidden allergen, in the form of an impurity collected during the industrial process, explaining some cases of allergic reactions to alkyl glucosides . Moreover, it has been recently reported as the cause of allergic contact dermatitis resulting from the use of continuous glucose monitoring systems and insulin pumps . Simultaneous reactions between IBOA and other acrylates were observed in only 2 patients, who were sensitized to ethyl acrylate and hydroxypropyl acrylate, respectively .…”

Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis caused by isobornyl acrylate in a young diabetic patient using a continous glucose monitoring system (Freestyle Libre)

et al. 2018

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Allergic contact dermatitis caused by isobornyl acrylate in OmniPod, an innovative tubeless insulin pump

Cited by 79 publications

References 8 publications

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set

Unexpected positive patch test reactions to sesquiterpene lactones in patients sensitized to the glucose sensor FreeStyle Libre

Allergic contact dermatitis caused by isobornyl acrylate in a young diabetic patient using a continous glucose monitoring system (Freestyle Libre)

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