ESPE Abstracts

Introduction: Glucose sensors are medical devices used in glycaemic control of patients with type 1 diabetes (T1D) . Its use prevents multiple capillary measurements, improving disease control and quality of life. However, these systems are not exempt from unforeseen events. The rise in the number of users has resulted in the increasing detection of local skin reactions by these devices, being the most frequent the eczematous ones, which may correspond to irritative or allergic contact dermatitis. Among allergens with sensitizing capacity, the most important is isobornyl acrylate (IBOA). Other allergens are 2.6- Di-tert-butyl-4-cresol (BHT), colophon, abitol, mixture of sesquiterpenic lactones and N, N-dimethylacrylamide.

Objective: Study the prevalence of skin reactions to glucose sensors (GS) and evaluate which ones are allergic to these substances.

Methods and Patients: Descriptive observational, carried out between 2019-2020 in 156 paediatric patients with T1D. Patients answered a survey about the development of skin injuries, referring them to a contact dermatitis unit. Epicutanous tests were performed on patients with suspicious allergic reaction.

Results: 93 patients (49 males) were tested (90= flash glucose monitoring system users, 1=Dexcom G6®, 1=Enlite®, 1=Guardian Connect 3®). Average age of patients was 11.8 (±3.7). Median time from the onset of DM1 to the date of the assessment was 5.2 years (IQR: 1.9 – 7), and 2.8 years (IQR: 1.3-4,1) from the start of the sensor. 36.6% (n = 34) of the individuals had some kind of reaction (31=flash glucose monitoring system, 1=Dexcom G6®, 1=Enlite®, 1=Guardian Connect 3®), of which only 8.4% had a history of skin atopia. 57.6% reported itching; 87.9% erythema; 27.3% flaking; 24.2% vesicles; 30.3% wounds and 39.4% changes in skin colour. 48.4% of the individuals who suffered any form of reaction used barrier methods, seeing improvement after its use by 57%. Five patients discontinued its use due to skin lesions. 10 of 34 patients who suffered a skin reaction were referred to the contact dermatitis unit. 2= contact dermatitis, 4= allergic contact dermatitis caused to black rubber // colophony rosin // IBOA // colophony rosin + IBOA (all flash glucose monitoring system users), 2= allergic contact dermatitis to sensor element –not parched- and 2= non-contact dermatitis.

Conclusions: Skin dermatitis is a frequent presenting complaint among glucose sensors users. The results of this study indicate that an evaluation of the skin area where the glucose sensor is placed must be introduced in our daily T1D clinics in order to improve and provide adequate care of our diabetic patients.