Barbara Davis Center for Childhood Diabetes, University of Colorado Denver , Aurora, Colorado.
Diabetes Technol Ther. 2018 Jun;20(S2):S254-S264. doi: 10.1089/dia.2018.0080.
Skin integrity and diabetes device placement are ongoing concerns for people with diabetes who utilize continuous glucose monitors (CGMs) and continuous subcutaneous insulin infusion pumps. This is especially significant for individuals with skin sensitivities, pediatric patients, and those who use devices chronically. Dermatological complications are often cited as a barrier to device use and a reason for device discontinuation. Furthermore, it is a frequent topic of discussion in diabetes follow-up visits, although little evidence-based literature exists to guide providers in managing skin integrity issues. The purpose of this article is to review current literature related to the prevalence of dermatological issues with insulin pumps and CGM, discuss published solutions to skin irritation, and to share the consolidated experience of our large academic diabetes clinic to address placement, prophylactic skin care, adhesives, removal, and skin healing with diabetes device use. Recommendations for targeted studies, increased surveillance, and development of new adhesive compounds are suggested to reduce the burden of device wear for management of diabetes.
皮肤完整性和糖尿病装置的放置是使用连续血糖监测仪 (CGM) 和持续皮下胰岛素输注泵的糖尿病患者持续关注的问题。对于皮肤敏感、儿科患者和长期使用设备的患者来说，这一点尤为重要。皮肤并发症常被认为是设备使用的障碍和设备停用的原因。此外，尽管在糖尿病随访中经常讨论这个问题，但几乎没有基于证据的文献来指导医生处理皮肤完整性问题。本文的目的是回顾与胰岛素泵和 CGM 相关的皮肤科问题的发生率，讨论已发表的解决皮肤刺激的方法，并分享我们大型学术糖尿病诊所的综合经验，以解决与糖尿病设备使用相关的放置、预防性皮肤护理、黏合剂、移除和皮肤愈合问题。建议进行有针对性的研究、加强监测和开发新的黏合化合物，以减轻设备佩戴的负担，从而更好地管理糖尿病。
