Columbia University Irving Medical Center, New York, NY, USA.
Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA.
J Diabetes Sci Technol. 2021 Jul;15(4):786-791. doi: 10.1177/1932296820918894. Epub 2020 May 9.
Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are the standard of care for type 1 diabetes in children. There is little reported on device-related skin complications and treatment options. This study documents cutaneous reactions to CGM and CSII devices in children and young adults with type 1 diabetes.
One hundred and twenty-one subjects (3-25 years) with type 1 diabetes and CGM and/or CSII use were recruited over a three-month period from the Naomi Berrie Diabetes Center at Columbia University Irving Medical Center. A five-question survey was completed for each subject detailing demographic data, diabetes management, and device-related skin complications.
Sixty percent of subjects reported skin complications related to CGM and/or CSII use. Terms most frequently used to describe cutaneous reactions were "red," "itchy," "painful," and "rash." Subjects who used both CGM and CSII were more likely to report skin problems than those who used only CSII (odds ratio 2.9, [95% confidence interval: 1.2-6.7]; = .015). There were no associations between skin complications and sex or race/ethnicity. Twenty-two percent of subjects with adverse skin event(s) discontinued use of a device due to their skin problem. Seven percent were evaluated by a dermatologist. Eighty-one percent used a range of products to treat their symptoms, with variable perceived clinical outcomes.
Skin complications related to CSII or CGM devices are commonly reported in pediatric patients with type 1 diabetes and may lead to interruption or discontinuation of device use. Future studies are needed to elucidate the causes of these reactions and determine the best methods for prevention.
连续血糖监测（CGM）和连续皮下胰岛素输注（CSII）是儿童 1 型糖尿病的标准治疗方法。关于设备相关的皮肤并发症和治疗选择的报道很少。本研究记录了 1 型糖尿病儿童和青少年使用 CGM 和 CSII 设备时的皮肤反应。
在哥伦比亚大学欧文医学中心的 Naomi Berrie 糖尿病中心，在三个月的时间内招募了 121 名（3-25 岁）使用 CGM 和/或 CSII 的 1 型糖尿病患者。为每位受试者完成了一份包含人口统计学数据、糖尿病管理和设备相关皮肤并发症的五问调查。
60%的受试者报告了与 CGM 和/或 CSII 使用相关的皮肤并发症。描述皮肤反应时最常使用的术语是“红色”、“瘙痒”、“疼痛”和“皮疹”。使用 CGM 和 CSII 的受试者比仅使用 CSII 的受试者更有可能报告皮肤问题（比值比 2.9，[95%置信区间：1.2-6.7]；=.015）。皮肤并发症与性别或种族/民族无关。22%的出现不良皮肤事件的受试者因皮肤问题停止使用设备。7%的受试者接受了皮肤科医生的评估。81%的人使用了一系列产品来治疗他们的症状，但治疗效果因人而异。
在患有 1 型糖尿病的儿科患者中，与 CSII 或 CGM 设备相关的皮肤并发症很常见，可能导致设备使用中断或停止。需要进一步的研究来阐明这些反应的原因，并确定预防的最佳方法。
