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Published on: June 11, 2012

Dermatological complications of continuous subcutaneous insulin infusion in children and adolescents

Louise S Conwell1, Elena Pope, Ana M Artiles

  • 1Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

The Journal of Pediatrics
|April 16, 2008
PubMed

Insights

Dermatological changes are common in youth with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) therapy. Lower adiposity correlated with more severe skin issues, but these rarely led to stopping treatment.

Area of Science:

  • Endocrinology
  • Dermatology
  • Pediatrics

Background:

  • Continuous subcutaneous insulin infusion (CSII) is a key therapy for type 1 diabetes mellitus (T1D).
  • Skin complications can arise from CSII, potentially impacting treatment adherence.

Purpose of the Study:

  • To characterize dermatological changes in youth with T1D undergoing CSII.
  • To investigate associations between these changes and clinical factors like duration of CSII, age, adiposity, glycemic control (HbA1c), insulin dose, and infusion site parameters.

Main Methods:

  • A cross-sectional study involved 50 T1D patients using CSII for over 6 months.
  • A grading scale assessed dermatological changes; ultrasound was used in a subset of patients.
  • Data on patient demographics, diabetes management, and CSII specifics were collected.

Main Results:

  • Frequent dermatological findings included small scars (94%), erythema (66%), nodules (62%), and lipohypertrophy (42%).
  • Higher severity scores correlated with lower body mass index z-scores (negative correlation).
  • Infusion set angle (90 degrees) was linked to lower severity scores; no correlations found with HbA1c or insulin brand.

Conclusions:

  • Dermatological complications are prevalent in pediatric CSII users but are not linked to glycemic control.
  • Reduced adiposity was associated with increased severity of skin changes.
  • Skin issues rarely prompted patients or parents to consider discontinuing CSII therapy.
Abstract

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