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“Out of the box” solution for skin problems due to glucose-monitoring technology in youth with type 1 diabetes: real-life experience with fluticasone spray

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Abstract

Background

Use of a continuous glucose-monitoring system (CGMS) in the management of type 1 diabetes (T1D) may cause local skin irritation.

Objective

To examine the effects of fluticasone propionate aqueous nasal solution (nsFP), sprayed topically prior to CGMS insertion among youth with T1D.

Methods

This is a case series observational report, including real-life 6-month follow-up data from one pediatric diabetes center. All patients suffering from local skin irritation due to CGMS adhesives were offered prevention form skin irritation by spraying 2 puffs of nsFP on the skin area prior to adhesion of CGMS. Data were collected from their charts after 6 months. Outcome measures included the difference in degree of skin irritation, number of days of CGMS use, BMI SDS, mean glucose, and HbA1c, prior to use and during 6 months after use.

Results

Twelve patients used nsFP prior to CGMS insertion, mean age 8.6 ± 4.9 years and 66.7% males. Ten patients, median age 6.1 years (5.3–9.5) and 56% males, continued using nsFP for a mean of 0.56 ± 0.11 years, with no recurrence of local irritation nor dermatitis to same adhesive material. No differences were found before and after use of nsFP in CGMS mean glucose 180 mg/dl (153–202) versus 165 mg/dl (150–192). BMI SDS was slightly higher 0.44 (− 0.9–1.2) versus 0.25 (− 0.47–1.06), P = 0.05.

Conclusions

This small-scale, single-site description of a simple intervention by nsFP and favorable outcome provides valuable insight for a simple solution for skin irritation and dermatitis in the pediatric population with T1D.

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Abbreviations

CGMS:

Continuous glucose-monitoring system

T1D:

Type 1 diabetes

nsFP:

Fluticasone propionate nasal spray

CSII:

Continuous subcutaneous insulin infusion

HbA1c:

Hemoglobin A1c, glycated hemoglobin

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Acknowledgements

We would like to thank Itzik Ortasi, the father of one of our patients, who first introduced us to the option of using nsFP, Dr Tomer Ziv for the statistical analysis and Camille Vainstein for English-language editing.

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Authors and Affiliations

  1. Pediatric Endocrinology Unit, Assaf Harofeh Medical Center, 70300, Zerifin, Israel

    Michal Paret, Galia Barash & Marianna Rachmiel

  2. Sackler School of Medicine, Tel Aviv University, 70300, Tel Aviv, Israel

    Marianna Rachmiel

Authors
  1. Michal Paret
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  2. Galia Barash
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  3. Marianna Rachmiel
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Corresponding author

Correspondence to Marianna Rachmiel.

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All authors have no conflict of interest.

Ethical approval

The study was conducted according to the Ethical tandards of care according to Helsinki and Human rights.

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Informed consent procedure was performed according to institutional ethical review board of the study.

Additional information

Communicated by Massimo Federici.

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Paret, M., Barash, G. & Rachmiel, M. “Out of the box” solution for skin problems due to glucose-monitoring technology in youth with type 1 diabetes: real-life experience with fluticasone spray. Acta Diabetol 57, 419–424 (2020). https://doi.org/10.1007/s00592-019-01446-y

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  • DOI: https://doi.org/10.1007/s00592-019-01446-y

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