Insulin Reactions: What Do You Do When Your Treatment’s the Trigger?

Edwards, Madeline; Liy‐Wong, Carmen; Byrne, Adam; Cowan, Kyle N.; Ahmet, Alexandra

doi:10.1016/j.jcjd.2022.08.006

Cited by 5 publications

(2 citation statements)

References 11 publications

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“…Edwards et al report worsening glycemic control paired with inflammatory dermatologic lesions associated with various insulin preparations in a 17-year-old girl. Following negative allergy testing to various insulin prep additives such as zinc, a type III hypersensitivity reaction was determined to be causative [32]. 12 papers in this review discussed the development of ACD as a significant barrier to device usage.…”

Section: Other Skin Manifestationsmentioning

confidence: 99%

“…Infusion site rotation was determined to be a feasible means of avoiding adverse lipodystrophy reactions suggesting the need for proper patient education regarding appropriate insulin administration on an individual basis to maintain quality of life regardless of dermatologic complications [24]. Components of insulin formulations are also known to contribute to cutaneous reactions [12,29,31,32,[35][36][37][38]. It is therefore important to identify and isolate reactions from pump components, insulin components, or the nature of a continuous infusion of reaction-provoking insulin.…”

Section: Other Skin Manifestationsmentioning

confidence: 99%

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Cutaneous Adverse Effects from Diabetes Devices in Pediatric Patients with Type 1 Diabetes Mellitus: a Systematic Review (Preprint)

Podwojniak,

Flemming,

Tan

et al. 2024

Preprint

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BACKGROUND Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusions (CSII) are the current standard treatment devices for type 1 diabetes (T1D) management. With a high prevalence of T1D beginning in pediatrics and carrying into adulthood, insufficient glycemic control leads to poor patient outcomes. Dermatologic complications such as contact dermatitis, lipodystrophies, and inflammatory lesions are among those associated with CGM and CSII, which reduce glycemic control and patient compliance. OBJECTIVE This systematic review aims to explore the current literature surrounding dermatologic complications of CGM, CSII, and the impact on patient outcomes. METHODS A systematic review of the literature was carried out using PRISMA 2020 guidelines utilizing five online databases. Included articles were those containing primary data relevant to human subjects and adverse CGM and CSII devices in pediatric populations of which greater than 50% of the sample size were ages 0-21. Qualitative analysis was chosen due to the heterogeneity of outcomes. RESULTS Following the application of exclusion criteria, 25 studies were analyzed and discussed. The most common complication covered is contact dermatitis with 12 identified studies. 6 studies concern lipodystrophies, 4 cover nonspecific cutaneous changes, and the remaining 3 cover unique cutaneous findings such as granulomatous reactions and panniculitis. CONCLUSIONS The dermatologic complications of CGM and CSII pose a potential risk to long-term glycemic control in T1D, especially in young patients where skin lesions can lead to discontinuation. Increased manufacturer transparency is critical and further studies are needed to expand upon the current preventative measures such as device site rotation and steroid creams, which lack consistent effectiveness.

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Section: Other Skin Manifestationsmentioning

confidence: 99%