Diedisheim Marc, Pecquet Catherine, Julla Jean-Baptiste, Carlier Aurelie, Potier Louis, Hartemann Agnès, Jacqueminet Sophie, Vidal-Trecan Tiphaine, Gautier Jean-François, Dubois Laforgue Danièle, Fagherazzi Guy, Roussel Ronan, Larger Etienne, Sola-Gazagnes Agnès, Riveline Jean-Pierre
Diabetology Department, Cochin Hospital, APHP, Paris, France.
Institut Necker Enfants Malades (INEM), INSERM U1151, CNRS UMR 8253, Université Paris Cité, IMMEDIAB Laboratory, Paris, France.
Diabetes Technol Ther. 2023 Apr;25(4):279-286. doi: 10.1089/dia.2022.0513. Epub 2023 Feb 24.
The use of continuous glucose monitoring (CGM) systems and continuous subcutaneous insulin infusion (CSII) devices adhering to the skin can lead to skin reactions. The objective was to determine the prevalence and consequences of skin reactions at CGM or CSII sites in a large unbiased population. This is a cross-sectional multicenter study. All adult patients with diabetes seen in consultation over a period of 7 months and using or having used a system with skin adhesives (in the last 10 years) were included and filled out a self-assessment questionnaire. Among 851 patients, skin reaction was reported in 28% with CGM and 29% with CSII. Patients reporting reactions were more frequently women using CGM and CSII, and CGM users had type 1 more often than type 2 diabetes ( < 0.001). Manifestations were similar for reactions to CGM and CSII: redness and pruritus in 70%-75% of patients with reactions, pain in 20%-25%, and vesicles and desquamation in 12%-15%. Manifestations occurred within the first 24 h of first use in 22%-24% of patients with reactions to CGM and CSII, but after more than 6 months in 38% and 47% of patients with reactions to CGM and CSII, respectively. Device use was definitively stopped in 12% of patients with reactions to CGM (3.2% of all users) and 7% with reactions to CSII (2.1% of all users). Skin reactions were common, with similar presentations in CGM and CSII users. Manifestations suggested skin irritation rather than allergies. These reactions rarely led to the definitive discontinuation of the use of the device.
使用贴于皮肤的连续血糖监测（CGM）系统和持续皮下胰岛素输注（CSII）设备可能会导致皮肤反应。目的是确定在一个无偏倚的大样本人群中，CGM或CSII部位皮肤反应的发生率及后果。这是一项横断面多中心研究。纳入了在7个月期间前来就诊、正在使用或过去10年内曾使用过带皮肤粘合剂系统的所有成年糖尿病患者，并让他们填写一份自我评估问卷。在851名患者中，报告有皮肤反应的CGM使用者占28%，CSII使用者占29%。报告有反应的患者中，使用CGM和CSII的女性更为常见，且CGM使用者中1型糖尿病患者比2型糖尿病患者更常见（<0.001）。CGM和CSII引起的反应表现相似：有反应的患者中，70%-75%出现发红和瘙痒，20%-25%出现疼痛，12%-15%出现水疱和脱屑。CGM和CSII有反应的患者中，分别有22%-24%在首次使用后的头24小时内出现这些表现，但分别有38%和47%的患者在使用超过6个月后出现。有CGM反应的患者中12%（占所有使用者的3.2%）以及有CSII反应的患者中7%（占所有使用者的2.1%）最终停止了设备使用。皮肤反应很常见，CGM和CSII使用者的表现相似。这些表现提示为皮肤刺激而非过敏。这些反应很少导致设备使用的最终停止。
