Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi," University of Messina, Messina, Italy.
Allergy Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi," University of Messina, Messina, Italy.
Diabetes Technol Ther. 2020 Jan;22(1):53-56. doi: 10.1089/dia.2019.0236.
In the past few years, the increasing use of devices for diabetes treatment, such as continuous subcutaneous insulin infusion pumps, flash glucose monitoring, continuous glucose monitoring systems, sensor-augmented pumps, and automated insulin delivery devices, has resulted in important improvements in disease management. Meanwhile, the longer a patient uses a device, the greater the likelihood of developing a skin reaction. Allergic contact dermatitis is the most frequently described skin side effect caused by adhesive tapes contained in the insulin infusion sets or glucose sensor sets and used to connect these devices to the body. We describe 18 patients, followed up at our Pediatric Diabetes Centre, who experienced dermatological complications due to diabetes device use from January 2018 to December 2018. All the patients were patch tested with allergens from a "standard" series and from a "plastics and glues" series. Patch tests resulted positive in 66.7% of patients. Colophonium was the most frequently isolated sensitizing allergen (41.1% of cases). It is a complex mixture of 100 compounds derived from pine trees. Colophonium is commonly used, in both unmodified and modified forms, as a fast-acting adhesive for industrial, medical, or other commercial uses. Its presence in the adhesive of the insulin sets and glucose sensors was confirmed by the manufacturer of some devices brand. On the basis of our results, we stress the importance of contacting manufacturers for product information. We also highlight that there should be stricter legal restrictions to label medical adhesives, even if only small amounts of colophonium are used.
在过去的几年中，糖尿病治疗设备的使用越来越多，例如连续皮下胰岛素输注泵、瞬态血糖监测仪、连续血糖监测系统、传感器增强泵和自动胰岛素输送设备，这导致疾病管理得到了重要改善。同时，患者使用设备的时间越长，发生皮肤反应的可能性就越大。过敏接触性皮炎是最常描述的由胰岛素输注套件或葡萄糖传感器套件中包含的粘性带引起的皮肤副作用，这些套件用于将这些设备连接到身体上。我们描述了 18 名在我们的儿科糖尿病中心接受随访的患者，他们在 2018 年 1 月至 2018 年 12 月期间因使用糖尿病设备而出现皮肤科并发症。所有患者均用“标准”系列和“塑料和胶水”系列过敏原进行斑贴试验。斑贴试验结果在 66.7%的患者中呈阳性。松香是最常分离出的致敏性过敏原（41.1%的病例）。它是一种源自松树的 100 种化合物的复杂混合物。松香广泛用于工业、医疗或其他商业用途的未改性和改性形式的快速胶粘剂。一些设备品牌制造商确认了松香存在于胰岛素套件和葡萄糖传感器的胶水中。基于我们的结果，我们强调了与制造商联系以获取产品信息的重要性。我们还强调，即使只使用少量的松香，也应该对医用胶粘剂进行更严格的法律限制。
