Cutaneous Reactions to Continuous Glucose Monitoring and Continuous Subcutaneous Insulin Infusion Devices in Type 1 Diabetes

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1591-P
Author(s):  
RACHEL K. SEVERIN ◽  
RACHELLE GANDICA ◽  
LAURA E. LEVIN ◽  
DONALD V. BELSITO ◽  
MARIA C. GARZON ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Glucose Monitoring ◽  
Subcutaneous Insulin ◽  
Infusion Devices ◽  
Cutaneous Reactions

scholarly journals Cutaneous Reactions to Continuous Glucose Monitoring and Continuous Subcutaneous Insulin Infusion Devices in Type 1 Diabetes Mellitus

2020 ◽  
pp. 193229682091889 ◽  
Author(s):  
Rachel S. Rigo ◽  
Laura E. Levin ◽  
Donald V. Belsito ◽  
Maria C. Garzon ◽  
Rachelle Gandica ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Diabetes Management ◽  
Demographic Data ◽  
Glucose Monitoring ◽  
Subcutaneous Insulin ◽  
Cutaneous Reactions

Background: Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are the standard of care for type 1 diabetes in children. There is little reported on device-related skin complications and treatment options. This study documents cutaneous reactions to CGM and CSII devices in children and young adults with type 1 diabetes. Methods: One hundred and twenty-one subjects (3-25 years) with type 1 diabetes and CGM and/or CSII use were recruited over a three-month period from the Naomi Berrie Diabetes Center at Columbia University Irving Medical Center. A five-question survey was completed for each subject detailing demographic data, diabetes management, and device-related skin complications. Results: Sixty percent of subjects reported skin complications related to CGM and/or CSII use. Terms most frequently used to describe cutaneous reactions were “red,” “itchy,” “painful,” and “rash.” Subjects who used both CGM and CSII were more likely to report skin problems than those who used only CSII (odds ratio 2.9, [95% confidence interval: 1.2-6.7]; P = .015). There were no associations between skin complications and sex or race/ethnicity. Twenty-two percent of subjects with adverse skin event(s) discontinued use of a device due to their skin problem. Seven percent were evaluated by a dermatologist. Eighty-one percent used a range of products to treat their symptoms, with variable perceived clinical outcomes. Conclusions: Skin complications related to CSII or CGM devices are commonly reported in pediatric patients with type 1 diabetes and may lead to interruption or discontinuation of device use. Future studies are needed to elucidate the causes of these reactions and determine the best methods for prevention.

scholarly journals Practical Approach to Using Trend Arrows on Real-Time Continuous Glucose Monitoring System in Type 1 Diabetes Adolescents Living Camp Setting Treated With Multiple Daily Injection or Continuous Subcutaneous Insulin Infusion Insulin Therapy

2020 ◽  
pp. 193229682093480
Author(s):  
Marta Bassi ◽  
Nicola Minuto ◽  
Graziella Fichera ◽  
Clara Rebora ◽  
Alice Parodi ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Real Time ◽  
Continuous Glucose Monitoring ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Training Session ◽  
Glucose Monitoring ◽  
Daily Injection ◽  
Subcutaneous Insulin

Background: The aim of the study was to determine the effect of an educational intervention on the use of trend arrows of a real-time continuous glucose monitoring (rt-CGM) to manage daily therapy decisions in a group of adolescents with type 1 diabetes attending a camp. The secondary aim was to evaluate the variations in total daily dose (TDD) of insulin requirement. Methods: Twenty patients (15-17 years) on multiple insulin injections ( n = 8) or continuous subcutaneous insulin infusion ( n = 12) attended a training session at the beginning of the camp to learn our algorithm for the management of therapy depending on trend arrows. TDD, time in range (TIR), time above range (TAR), and time below range (TBR) (in the 24 hours and in the three hours after breakfast) before the training session (run-in) and at the end of the camp (T1) were analyzed. Results: Data showed a reduction of TAR (run-in 42.6%, T1 32.05%, P = .036) and an increase in TIR (run-in 52.9%, T1 62.4%, P = .013). Reduction of TBR (run-in 42.5%, T1 37.5%, P = .05) and improvement in TIR (run-in 49.0%, T1 57.0%, P = .02) were also observed in the post-breakfast period. Data showed a significant reduction in the TDD (run-in 52.02 ± 17.44 U/die, T1 46.49 ± 12.39 U/die, P = .024). Conclusions: Statistically significant improvement of glycemic control and reduction of TTD were observed in all patients regardless of therapy type. The improvement between run-in and T1 demonstrates the importance of patients’ education on the correct use of rt-CGM with simple algorithms for the management of therapy.

Use of Personal Continuous Glucose Monitoring Device Is Associated With Reduced Risk of Hypoglycemia in a 16-Week Clinical Trial of People With Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion

2020 ◽  
pp. 193229682095766
Author(s):  
Morten Hasselstrøm Jensen ◽  
Peter Vestergaard ◽  
Irl B. Hirsch ◽  
Ole Hejlesen
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Rate Ratio ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Event Rate ◽  
Glucose Monitoring ◽  
Subcutaneous Insulin

Aims: Continuous glucose monitoring (CGM) has the potential to promote diabetes self-management at home with a better glycemic control as outcome. Investigation of the effect of CGM has typically been carried out based on randomized controlled trials with prespecified CGM devices on CGM-naïve participants. The aim of this study was to investigate the effect on glycemic control in people using their personal CGM before and during the trial. Materials and Methods: Data from the Onset 5 trial of 472 people with type 1 diabetes using either their personal CGM ( n = 117) or no CGM ( n = 355) and continuous subcutaneous insulin infusion in a 16-week treatment period were extracted. Change from baseline in glycated hemoglobin A1c (HbA1c), number of hypoglycemic episodes, and CGM metrics at the end of treatment were analyzed with analysis of variance repeated-measures models. Results: Use of personal CGM compared with no CGM was associated with a reduction in risk of documented symptomatic hypoglycemia (event rate ratio: 0.82; 95% CI: 0.69-0.97) and asymptomatic hypoglycemia (event rate ratio: 0.72; 95% CI: 0.53-0.97), reduced time spent in hypoglycemia ( P = .0070), and less glycemic variability ( P = .0043) without a statistically significant increase in HbA1c ( P = .2028). Conclusions: Results indicate that use of personal CGM compared with no CGM in a population of type 1 diabetes is associated with a safer glycemic control without a statistically significantly deteriorated effect on HbA1c, which adds to the evidence about the real-world use of CGM, where device type is not prespecified, and users are not CGM naïve.

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