Insulin Pump Therapy and Adverse Skin Reactions With Focus on Allergic Contact Dermatitis in Individuals Living With Diabetes Mellitus: A Systematic Review and Clinical-Based Update.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Science and Technology Pub Date : 2024-11-01 Epub Date: 2024-06-10 DOI:10.1177/19322968241252613
Laura Beate von Kobyletzki, Josefin Ulriksdotter, Elisa von Kobyletzki, Martin Mowitz, Johan Jendle, Cecilia Svedman
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Abstract

Background: The use of insulin pumps (continuous subcutaneous insulin infusion [CSII]) in individuals living with type 1 diabetes (T1D) improves disease control. However, adverse skin reactions may hamper compliance. We aimed to assess the relationship of insulin pumps, particularly that of infusion set therapy, used in children and adults with T1D and dermatitis including allergic contact dermatitis (ACD).

Methods: A systematic search of PubMed, and EMBASE, of full-text studies reporting dermatitis in persons with diabetes using a CSII was conducted from 2020 to 2023. The Newcastle-Ottawa Scale was used to assess study quality. The inventory performed at the Department of Occupational and Environmental Dermatology, Malmö, Sweden (YMDA) was also performed highlighting the diagnostic process.

Results: Among the 391 screened abstracts, 21 studies fulfilled the inclusion criteria. Seven studies included data on children only, four studies were on adults, and nine studies reported data on both children and adults. Participants were exposed to a broad range of pumps. Dermatitis was rarely specified. Up to 60% of those referred to a university hospital due to skin reactions possibly related to insulin pumps had an ACD.

Conclusions: The review and our findings indicate that there is not sufficient focus on contact allergy in the primary toxicological evaluations of substances used also for insulin pump therapy products and that possible adverse skin reactions are not correctly followed up in the clinical setting.

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胰岛素泵疗法与皮肤不良反应,重点关注糖尿病患者的过敏性接触性皮炎:系统回顾与临床更新。
背景:1 型糖尿病(T1D)患者使用胰岛素泵(持续皮下注射胰岛素 [CSII])可改善疾病控制。然而,皮肤不良反应可能会影响患者的依从性。我们旨在评估 T1D 儿童和成人患者使用的胰岛素泵(尤其是输注装置疗法)与皮炎(包括过敏性接触性皮炎 (ACD))之间的关系:从 2020 年到 2023 年,在 PubMed 和 EMBASE 上对报道使用 CSII 的糖尿病患者皮炎的全文研究进行了系统检索。采用纽卡斯尔-渥太华量表评估研究质量。瑞典马尔默职业与环境皮肤病学系(YMDA)也进行了盘点,以突出诊断过程:在筛选出的 391 份摘要中,有 21 项研究符合纳入标准。其中 7 项研究仅包含儿童数据,4 项研究包含成人数据,9 项研究同时报告了儿童和成人数据。参与者接触的泵种类繁多。皮炎很少被明确指出。在因可能与胰岛素泵有关的皮肤反应而转诊到大学医院的患者中,多达 60% 的人患有 ACD:综述和我们的研究结果表明,在对胰岛素泵治疗产品所用物质进行初级毒理学评估时,并未充分关注接触过敏问题,而且在临床环境中也未对可能出现的皮肤不良反应进行正确跟踪。
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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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