Dermatological side effects and complications of continuous subcutaneous insulin infusion in preschool-age and school-age children

Schober, Edith; Rami, Birgit

doi:10.1111/j.1399-5448.2008.00477.x

Cited by 43 publications

(57 citation statements)

References 18 publications

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“…In studies assessing dermatologic complications of CSII therapy in children (predominately using Teflon catheters), scars > 3 mm occurred in 12-37% of patients, subcutaneous erythematous nodules in 21-42%, erythema without nodules in 25-66%, and abscesses in 8-12% (abscesses were counted from onset of CSII therapy). 13,14 In the present study there was a 14% incidence of erythema and induration of > 10 mm when sets were worn up to 7 days, all occurring after 3 days of set wear, and there were three site infections, all occurring in the same patient.…”

Section: Figsupporting

confidence: 46%

Randomized Trial of Infusion Set Function: Steel Versus Teflon

Patel

Benasi²,

Ferrari³

et al. 2014

Diabetes Technology & Therapeutics

100

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Background: This study compared infusion set function for up to 1 week using either a Teflon Ò (Dupont Ô , Wilmington, DE) catheter or a steel catheter for insulin pump therapy in type 1 diabetes mellitus. Subjects and Methods: Twenty subjects participating in a randomized, open-labeled, crossover study were asked to wear two Quick-Set Ò and two Sure-T Ò infusion sets (both from Medtronic Minimed, Northridge, CA) until the infusion set failed or was worn for 1 week. All subjects wore a MiniMed continuous glucose monitoring system for the duration of the study. Results: One subject withdrew from the study. There were 38 weeks of Sure-T wear and 39 weeks of Quick-Set wear with no difference in the survival curves of the infusion sets. There was, however, a 15% initial failure rate with the Teflon infusion set. After 7 days, both types of infusion sets had a 64% failure rate. Overall, 30% failed because of hyperglycemia and a failed correction dose, 13% were removed for pain, 10% were pulled out by accident, 10% had erythema and/or induration of > 10 mm, 5% fell out because of loss of adhesion, and 4% were removed for infection. The main predictor of length of wear was the individual subject. There was no increase in hyperglycemia or daily insulin requirements when an infusion set was successfully used for 7 days (n = 25 of 77 weeks). Conclusions: We found no difference between steel and Teflon infusion sets in their function over 7 days, although 15% of Teflon sets failed because of kinking on insertion. The strongest predictor of prolonged 7-day infusion set function was the individual subject, not the type of infusion set.

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Section: Figsupporting

confidence: 46%

Randomized Trial of Infusion Set Function: Steel Versus Teflon

Patel

Benasi²,

Ferrari³

et al. 2014

Diabetes Technology & Therapeutics

100

View full text Add to dashboard Cite

show abstract

“…Another evaluation of dermatological side effects and complications of CSII in school-age children and preschool-age children showed that skin problems are no more frequent or severe in very young children (<6 years) compared to school-age patients: scars <3 mm: 50% vs 75%; erythema: 25% vs 26%; nodules: 30% vs 21%; LHT: 45% vs 47%. 52 Blisters and local abscesses were rare in this study, and no participant required surgery. The calculated frequency of skin side effects per IIS usage year was 0.06 vs 0.04.…”

Section: Skin Problemsmentioning

confidence: 94%

Insulin Infusion Set: The Achilles Heel of Continuous Subcutaneous Insulin Infusion

Heinemann¹,

Krinelke

2012

J Diabetes Sci Technol

124

143

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Continuous subcutaneous insulin infusion from an insulin pump depends on reliable transfer of the pumped insulin to the subcutaneous insulin depot by means of an insulin infusion set (IIS). Despite their widespread use, the published knowledge about IISs and related issues regarding the impact of placement and wear time on insulin absorption/insulin action is relatively small. We also have to acknowledge that our knowledge is limited with regard to how often patients encounter issues with IISs. Reading pump wearer blogs, for instance, suggests that these are a frequent source of trouble. There are no prospective clinical studies available on current IIS and insulin formulations that provide representative data on the type and frequency of issues with infusion sets. The introduction of new IISs and patch pumps may foster a reassessment of available products and of patient problems related to their use. The aim of this review is to summarize the current knowledge and recommendations about IISs and to highlight potential directions of IIS development in order to make insulin absorption safer and more efficient.

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“…This study also reported a low rate of discontinuation (of between 2 and 4 %) due to skin complications. Similarly, another cross-sectional study of 78 paediatric patients also found frequent experience of scarring, nodules, and erythema [31].…”

Section: Other Skin Complicationsmentioning

confidence: 95%

“…Infection was the most common issue reported in older studies [8,31,32]. Earliest reported data showed that 29 % of patients experienced an infected infusion site at some point, most commonly presenting as cellulitis [8].…”

Section: Infectionmentioning

confidence: 96%

Clinical review: insulin pump-associated adverse events in adults and children

et al. 2015

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This timely review covers all potential insulin pump-associated adverse events, including their incidence, features, impacts, and contributory factors such as the pump user. The importance of ongoing anticipatory education and support for patients and families using this intensive insulin technology is highlighted, which if done well should improve the overall experience of pump therapy for users, and hopefully reduce the incidence and impact of severe adverse events.

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Dermatological side effects and complications of continuous subcutaneous insulin infusion in preschool-age and school-age children

Abstract: Dermatological side effects during CSII are not more frequent or severe in very young diabetic children compared with diabetic children in school age.

Cited by 43 publications

References 18 publications

Randomized Trial of Infusion Set Function: Steel Versus Teflon

Randomized Trial of Infusion Set Function: Steel Versus Teflon

Insulin Infusion Set: The Achilles Heel of Continuous Subcutaneous Insulin Infusion

Clinical review: insulin pump-associated adverse events in adults and children

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