Fatal Necrotizing Soft Tissue Infection Following Continuous Glucose Monitoring in a Patient with Type 1 Diabetes: A...

Continuous glucose monitoring (CGM) systems have significantly improved glycemic management in patients with type 1 diabetes mellitus and are generally considered safe. However, transcutaneous sensor insertion disrupts the skin barrier and, in susceptible individuals, may contribute to infectious complications. Severe soft tissue infections occurring in temporal association with CGM use are exceedingly rare.

We report a fatal case of necrotizing soft tissue infection in a 54-year-old male with long-standing type 1 diabetes mellitus occurring in temporal association with CGM use. The patient initially developed localized inflammation at a prior sensor insertion site that failed to fully resolve. Over subsequent weeks, he experienced progressive systemic symptoms and worsening local findings, culminating in advanced necrotizing infection. Despite emergency surgical debridement, broad-spectrum antimicrobial therapy, and intensive care support, the clinical course was complicated by septic shock and multiorgan failure, resulting in death.

This case highlights the role of patient-specific vulnerability, persistent insertion-site inflammation, and delayed clinical recognition in the progression from localized skin changes to life-threatening infection. Importantly, this report does not establish a direct causal relationship between CGM use and necrotizing soft tissue infection but underscores the need for heightened vigilance in high-risk individuals.

Although CGM systems have a favorable safety profile, careful inspection of insertion sites, avoidance of sensor reapplication over incompletely healed tissue, and early evaluation of persistent or progressive symptoms are essential to minimize the risk of severe outcomes in susceptible patients.