Contact dermatitis caused by glucose sensors in diabetic children

Herman, Anne; Darrigade, Anne‐Sophie; Montjoye, Laurence de; Baeck, Marie

doi:10.1111/cod.13429

Cited by 28 publications

(24 citation statements)

References 22 publications

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“…Interestingly, in this report, positive patch test results to IBOA 0.1% on D3 were seen in only 67% of the patients. The prevalence of IBOA sensitization among all FreeStyle Libre users has previously been estimated to 0.7% 7 and 3.8%, 20 respectively, among adults and 4.2% 9 among children. However, because not all users are patch tested the true frequency is most likely higher.…”

Section: Discussionmentioning

confidence: 99%

“…In this report, 87% of the patients were sensitized to IBOA. In previous studies, IBOA sensitization prevalence has been estimated to be 68%‐83.3% 7,9,20 among FreeStyle Libre users with sensor‐related adverse skin reactions. In those studies, IBOA was patch tested at a maximum concentration of 0.1% and patch test readings on D7 were not routinely performed.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years IBOA has gained increased attention as a contact allergen causing ACD to medical devices used in diabetes monitoring and treatment 18 . IBOA has been identified in the glucose sensors FreeStyle Libre and Enlite (Medtronic MiniMed, Northridge, California), Omnipod insulin pump (Insulet Corporation, Billerica, Massachusetts), and the insulin infusion set Paradigm MiniMed Quick‐set (Medtronic, Minneapolis, Minnesota) 4‐7,9 . DMAA has been identified as an additional sensitizer in FreeStyle Libre and Enlite 6,8 .…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, several cases of allergic contact dermatitis (ACD) to the glucose sensor FreeStyle Libre (Abbott Diabetes Care, Witney, UK) have been reported. Isobornyl acrylate (IBOA) and N,N ‐dimethylacrylamide (DMAA) have been identified as major culprit allergens 4‐9 . Believed to derive from an adhesive used to join the top and bottom part of the plastic housing of the sensor, IBOA and DMAA have been identified in Freestyle Libre through gas chromatography‐mass spectrometry (GC‐MS) analyses 4,8 .…”

Section: Introductionmentioning

confidence: 99%

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Contact dermatitis caused by glucose sensors—15 adult patients tested with a medical device patch test series

et al. 2020

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Background Several cases of allergic contact dermatitis (ACD) to the glucose sensor FreeStyle Libre have been reported. Isobornyl acrylate (IBOA) and N,N‐dimethylacrylamide (DMAA) are known culprit allergens. Objectives To evaluate patients with suspected ACD to FreeStyle Libre in a standardized manner, present causative allergens, and assess patient‐reported implications. Methods A total of 15 patients with suspected ACD to FreeStyle Libre were patch tested with the Swedish baseline series and a new medical device series. IBOA and DMAA were tested at 0.1% and 0.3% in petrolatum (pet.). Readings were performed on day (D) 3 and D7. Background data, details on skin reactions, and associated implications were assessed using a questionnaire. Results Thirteen patients were sensitized to IBOA and four to DMAA. Two positive reactions to IBOA and one to DMAA were seen only at 0.3% concentration on D7. Median duration of sensor use before dermatitis onset was 6 months. Half the number of the patients took precautions in everyday life due to sensor‐related skin reactions. Six patients discontinued sensor usage. Conclusions Patients with suspected ACD to glucose sensors should be evaluated with a relevant patch test series containing IBOA and DMAA. Adding the 0.3% pet. concentration is recommended. The reading on D7 is necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contact dermatitis caused by glucose sensors—15 adult patients tested with a medical device patch test series

et al. 2020

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“…It has been found that skin reactions constitute one of the main causes of treatment discontinuation 14–16 ). Also, children have been found to have skin reactions 17 to insulin pumps and CGM/FGMs. In one study, 18 more than 60% of patients using insulin pumps reported current dermatological complications and more than 45% of those using CGM/FGM.…”

Section: Introductionmentioning

confidence: 99%

Continuous glucose monitoring systems give contact dermatitis in children and adults despite efforts of providing less ‘allergy‐ prone’ devices: investigation and advice hampered by insufficient material for optimized patch test investigations

Svedman

Bruze

Antelmi

et al. 2021

Acad Dermatol Venereol

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Background Medical devices are increasingly being reported to cause contact allergic dermatitis reactions. Objective Review of patients with diabetes type I referred for suspected allergic contact dermatitis to insulin pump or glucose sensor systems. Method: We have reviewed 11 referred diabetes mellitus patients investigated for allergic contact dermatitis reactions to medical devices and specifically Dexcom G6®. Extracts from the medical devices were analysed. Results The majority of patients was children, the majority had relevant allergies and particularly allergy to isobornyl acrylate which was also found in the glucose sensor system Dexcom G6®. Conclusions The following case reports bring in focus the fact that patients sensitized through use of one medical device and being advised the use of another, or find another product for a while useful, are not by necessity free from future episodes of allergic contact dermatitis. The case reports emphasize the need for collaboration since it is impossible for even well‐equipped laboratories to properly investigate the medical devices when information on the substances used in production is not uniform and complete and material to investigate are scarce. The importance of adequate patch test series and testing with own material and furthermore the importance to re‐analyse medical devices and re‐analyse test data are emphasized.

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Automated insulin delivery: benefits, challenges, and recommendations. A Consensus Report of the Joint Diabetes Technology Working Group of the European Association for the Study of Diabetes and the American Diabetes Association

Sherr

Heinemann²,

Fleming³

et al. 2022

Diabetologia

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A technological solution for the management of diabetes in people who require intensive insulin therapy has been sought for decades. The last 10 years have seen substantial growth in devices that can be integrated into clinical care. Driven by the availability of reliable systems for continuous glucose monitoring, we have entered an era in which insulin delivery through insulin pumps can be modulated based on sensor glucose data. Over the past few years, regulatory approval of the first automated insulin delivery (AID) systems has been granted, and these systems have been adopted into clinical care. Additionally, a community of people living with type 1 diabetes has created its own systems using a do-it-yourself approach by using products commercialised for independent use. With several AID systems in development, some of which are anticipated to be granted regulatory approval in the near future, the joint Diabetes Technology Working Group of the European Association for the Study of Diabetes and the American Diabetes Association has created this consensus report. We provide a review of the current landscape of AID systems, with a particular focus on their safety. We conclude with a series of recommended targeted actions. This is the fourth in a series of reports issued by this working group. The working group was jointly commissioned by the executives of both organisations to write the first statement on insulin pumps, which was published in 2015. The original authoring group was comprised by three nominated members of the American Diabetes Association and three nominated members of the European Association for the Study of Diabetes. Additional authors have been added to the group to increase diversity and range of expertise. Each organisation has provided a similar internal review process for each manuscript prior to submission for editorial review by the two journals. Harmonisation of editorial and substantial modifications has occurred at both levels. The members of the group have selected the subject of each statement and submitted the selection to both organisations for confirmation.

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Contact dermatitis caused by glucose sensors in diabetic children

Cited by 28 publications

References 22 publications

Contact dermatitis caused by glucose sensors—15 adult patients tested with a medical device patch test series

Contact dermatitis caused by glucose sensors—15 adult patients tested with a medical device patch test series

Continuous glucose monitoring systems give contact dermatitis in children and adults despite efforts of providing less ‘allergy‐ prone’ devices: investigation and advice hampered by insufficient material for optimized patch test investigations

Automated insulin delivery: benefits, challenges, and recommendations. A Consensus Report of the Joint Diabetes Technology Working Group of the European Association for the Study of Diabetes and the American Diabetes Association

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