Severe allergic contact dermatitis to two different continuous glucose monitoring devices in a patient with glycogen storage disease type 9b

Abstract

Continuous glucose monitoring (CGM) systems are increasingly implemented in patients with diabetes and other disorders with disturbed glucose homeostasis to promote good metabolic control.However, shortly after their appearance on the market, the first concerns about adverse skin reactions were raised. 1 CGM devices are usually combined with a subcutaneous catheter and a transmitter for blood glucose sensors applied to the skin by an adhesive patch for a period of 3-14 days. 2 Dermatological complications are especially common in children and adolescents using GCM devices. 3 Herman et al have recently identified isobornyl acrylate as the main culprit allergen to cause allergic contact dermatitis (ACD) in patients using the FreeStyle ® Libre device. 2 Interestingly, isobornyl acrylate was the American Contact Dermatitis Society Allergen of the Year in 2020. 4 We herein report on a girl with glycogen storage disease (GSD) type 9b who developed severe ACD to both FreeStyle ® Libre and Dexcom ® G6 devices. Our case highlights the severe consequences of sensitization for pediatric patients and the urgent need for open labeling as well as the use of less allergenic adhesives and components in medical devices.

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

“…In 2020, IBOA earned the title of American Contact Dermatitis Society Allergen of the year [33]. Manufacturer acknowledgment of IBOA in their devices is mixed, with some companies denying awareness of its presence in products [34]. Nevertheless, the overwhelming evidence of IBOA as an agent of contact dermatitis should be sufficient to produce consumer warnings and patient transparency.…”