Skin Problems Associated with Insulin Pumps and Sensors in Adults with Type 1 Diabetes: A Cross-Sectional Study
Skin Problems Associated with Insulin Pumps and Sensors in Adults with Type 1 Diabetes: A Cross-Sectional Study
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DOI：
10.1089/dia.2018.0088
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发表时间：
2018-06-12
影响因子：
5.4
通讯作者：
Svensson, Jannet
中科院分区：
文献类型：
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作者：
Berg, Anna Korsgaard;Norgaard, Kirsten;Svensson, Jannet
背景资料：未来，广泛使用闭环输注（人工胰腺）系统治疗1型糖尿病（T1 D）可能会显著改善血糖控制并增强治疗灵活性。然而，这些治疗所需的输液器和膏药可能会导致皮肤病并发症，这可能会阻碍新技术的传播;很少有研究调查成人的这些并发症。本研究的目的是描述与成人持续皮下胰岛素输注（CSII）和持续血糖监测（CGM）相关的皮肤病并发症。研究方法：来自两个不同糖尿病诊所的共118名成人患者完成了一份问卷，内容涉及与CSII和/或CGM治疗相关的皮肤并发症、其他治疗变量、糖尿病持续时间、过敏、皮肤护理和其他病理。结果：CGM或CSII的使用与目前的湿疹、疤痕和伤口有关。总体而言，34%的CSII用户和35%的CGM用户目前因使用这些器械而出现一处或多处皮肤病变。我们没有发现与糖化血红蛋白（HbA 1c）水平，特应性皮炎病史或其他皮肤病理学有显著相关性。然而，多变量分析显示与过敏史和CSII相关的皮肤病并发症相关。结论：每三名患者中就有一名出现皮肤并发症，这对使用CSII和CGM治疗成人T1 D患者来说是一个重大挑战。需要对这些并发症的原因进行前瞻性研究，以制定预防策略，并确保可以实施利用最新技术的最佳糖尿病治疗方法。
Background: In the future, widespread use of closed-loop infusion (artificial pancreas) systems to treat type 1 diabetes (T1D) may significantly improve glycemic control and enhance treatment flexibility. However, the infusion sets and plasters necessary for these treatments can cause dermatological complications that may hamper the spread of the new technology; few studies have investigated these complications in adults. The aim of this study was to describe the dermatological complications associated with continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) in adults. Methods: A total of 118 adult patients from two different diabetes clinics completed a questionnaire concerning the dermatological complications associated with their CSII and/or CGM treatment, other treatment variables, duration of diabetes, allergies, skin care, and other pathologies. Results: CGM or CSII use was associated with current eczema, scars, and wounds. In total, 34% of CSII users and 35% of CGM users currently had one or more skin lesions due to the use of these devices. We found no significant association with glycated hemoglobin (HbA1c) levels, a history of atopic dermatitis, or other skin pathologies. However, multivariate analysis revealed associations with a history of atopy and CSII-associated dermatological complications. Conclusions: Dermatological complications were present in one in every three patients and represent a significant challenge to using CSII and CGM to treat adults with T1D. Prospective studies on the causes of these complications will be required to develop preventive strategies and ensure that optimal diabetes treatment approaches that take advantage of the latest technology can be implemented.