isobornyl-acrylate and Diabetes-Mellitus

Insulin pumps and glucose monitoring devices improve diabetes mellitus control and enhance patients' quality of life. However, a growing number of adverse cutaneous reactions related to the use of these devices have been reported.. To investigate the culprits of localized contact dermatitis in paediatric patients with diabetes caused by insulin pumps and glucose monitoring devices.. Retrospective analysis of 15 paediatric patients patch tested as part of a clinical investigation for skin reactions associated with insulin pumps and glucose monitoring devices.. Seven patients had positive patch test reactions to isobornyl acrylate (IBOA) and five had positive reactions to benzoyl peroxide (BP). Positive patch test reactions to materials from the glucose sensor and/or insulin pump were seen in 10 of the 15 patients. Three had positive reactions to adhesive remover wipe from Smith and Nephew Remove and four had reactions to EMLA plaster.. A high share of patients showed positive reactions to IBOA and/or their medical devices (insulin pumps or glucose devices). A third of patients showed positive reactions to BP. The presence of additional unidentified allergens cannot be excluded, highlighting the importance of access to a full description of the chemical composition of the devices.

Topics: Acrylates; Adhesives; Allergens; Benzoyl Peroxide; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Humans; Insulins; Patch Tests; Quality of Life; Retrospective Studies

Medical devices (MD) in close skin-contact for a prolonged time, such as glucose monitoring (CGM) systems, are a risk factor for contact allergy, and there has been an increase in patients using these. Correct diagnosis demands targetted testing.. We report a new allergen in a continuous CGM system in which the adhesive was changed. The allergy pattern of the patients diagnosed is reported.. The three patients reported were patch tested with an MD series, own material, and possible allergens found through analysis with gas chromatography-mass spectrometry, comparing analysis from the CGM system before and after change.. The patients were sensitized to isobornyl acrylate (IBOA), found in previously used devices and the present CGM. Apart from IBOA, the culprit allergen was found to be 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate.. Allergic contact dermatitis due to CGM systems and insulin pumps are difficult to investigate and require chemical analysis. Because of the lack of information on substances used in the production, and when changes with MDs are initiated, it is difficult to advise patients, especially since they risk sensitization to several allergens. The use of MDs has increased and, thus, the need for collaboration between manufacturers, clinicians, and patient organizations.

Topics: Acrylates; Adhesives; Adult; Blood Glucose Self-Monitoring; Butylated Hydroxytoluene; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus; Female; Humans; Male; Patch Tests

Cutaneous adverse events (CAE) from FreeStyle Libre include allergic contact dermatitis (ACD) caused by the allergen isobornyl acrylate (IBOA). We aim to report CAE from this glucose sensor, ACD to IBOA in particular, and the outcome of using barrier films as a prevention.. A monocentric, retrospective review of medical files from adult and pediatric patients with diabetes using Freestyle Libre, in the period between December 2016 and April 2019, was performed with a focus on CAE.. Fifty-seven of 1,036 patients with diabetes (5.5%) were referred to our dermatology department because of CAE from FreeStyle Libre. Thirty-nine of 1,036 (3.8%) had ACD due to IBOA. Only two patients, of whom one sensitized to IBOA, had a benefit from using barrier films.. CAE occurred in 5.5% of FreeStyle Libre users, and 3.8% suffered from ACD due to IBOA. Barrier films had limited value in the prevention.

Topics: Acrylates; Adolescent; Adult; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Equipment and Supplies; Female; Humans; Insulin; Insulin Infusion Systems; Male; Middle Aged; Prevalence; Retrospective Studies; Young Adult

Adverse cutaneous reactions to diabetes medical devices (glucose sensors and insulin pumps) are described, notably allergic contact dermatitis (ACD) with isobornyl acrylate (IBOA) and N,N dimethylacrylamide (DMAA) as the main allergen.. To determine if all cases of adverse cutaneous reactions observed with diabetes medical devices (ie FreeStyle Libre, Enlite sensors or insulin pumps), referred to our department with suspected allergies are confirmed as ACD.. Fifty-two patients who presented skin reactions to diabetes medical devices were patch tested with the European baseline series, a plastic and glues series, a (meth) acrylates series, a piece of the adhesive part of the device, as well as IBOA 0.1% and DMAA 0.1% pet.. Seventeen patients had no positive reaction to IBOA nor to the adhesive part of the device; 11 of these also tested with DMAA with negative result. No other relevant allergen was identified.. Some cutaneous reactions, otherwise very similar to those of patients sensitized to IBOA, can be explained either by the presence of an untested allergen not yet discovered, or by irritant contact dermatitis. Therefore, European legislation on the full labelling of ingredients by manufacturers, in order to facilitate the identification of allergens and irritants, is imperative.

Topics: Acrylamides; Acrylates; Adhesives; Adolescent; Adult; Aged; Aged, 80 and over; Blood Glucose Self-Monitoring; Camphanes; Child; Child, Preschool; Dermatitis, Allergic Contact; Dermatitis, Irritant; Diabetes Mellitus; Equipment and Supplies; Female; Humans; Infusion Pumps, Implantable; Insulin Infusion Systems; Male; Middle Aged; Young Adult

Topics: Acrylates; Adult; Aged; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus; Female; Humans; Male; Middle Aged; Patch Tests; Portugal; Tertiary Care Centers; Young Adult

Diabetic devices including glucose monitoring systems and insulin pumps are used worldwide and are increasingly recognized as a source of irritant contact dermatitis and allergic contact dermatitis (ACD). Isobornyl acrylate is a chemical used in the glue of some of these devices and has been implicated as a frequent culprit allergen in patients who become sensitized to their device. Patch testing with isobornyl acrylate 0.1% in petrolatum is not necessary in standard screening panels but should be considered in patients with suspected ACD to glucose sensors or insulin pumps.

Topics: Acrylates; Allergens; Blood Glucose; Blood Glucose Self-Monitoring; Camphanes; Dermatitis, Allergic Contact; Diabetes Mellitus; Humans; Patch Tests; United States

Isobornyl acrylate (IBOA) has recently been identified as one sensitizer in the FreeStyle Libre glucose sensor. Analyses with gas chromatography-mass spectrometry (GC-MS) have indicated the presence of N,N-dimethylacrylamide (DMAA) in the sensor.. Seven patients were referred for patch testing after developing skin reactions when using FreeStyle Libre. All patients were patch tested with IBOA and DMAA. Two patients were tested with adhesive patches that had been removed from the sensors "as is," and two patients were tested with acetone extracts of materials from the sensor. The extracts were analysed with GC-MS.. Six patients reacted to both IBOA and DMAA, and one patient reacted only to DMAA. Positive reactions were also observed in both patients tested with the adhesive patch "as is". One patient reacted to both an extract of the adhesive patch and an extract of the sensor itself. When analysed with GC-MS, IBOA was found in both extracts and DMAA was found in the extract of the sensor.. Both IBOA and DMAA may be present in adhesives used in medical devices such as glucose sensors or insulin pumps, and should be patch tested when suspected contact allergic reactions to these products are investigated.

Topics: Acrylamides; Acrylates; Adhesives; Adult; Aged; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Disease Management; Female; Humans; Male; Middle Aged

Glucose monitoring systems, for example, Freestyle Libre (Abott) and Dexcom (Nintamed), are increasingly being used instead of conventional blood sugar measurement. However, many patients have experienced adverse skin reactions such as severe allergic contact dermatitis (ACD). Finally, in August 2017, the culprit allergen in Freestyle Libre, isobornyl acrylate (IBOA), was identified.. After patients have developed ACD, it is recommended that they no longer use their glucose monitoring systems. Thus, it is important to find an alternative IBOA-free device.. Five patients presented with ACD caused by Freestyle Libre. Each was patch tested with allergens from the baseline series and from a plastics and glues series, and additionally with IBOA 0.1% pet. Gas chromatography-mass spectrometry (GC/MS) of the Freestyle Libre sensor and the Dexcom sensor was performed. The Dexcom sensor remained on the skin of all patients for at least 2 days.. All patients were sensitized to IBOA. GC/MS showed the presence of IBOA in the Freestyle Libre sensor, whereas the Dexcom sensor was IBOA-free. None of the patients had skin reactions to the Dexcom sensor.. Patients with Freestyle Libre and IBOA allergy may use the Dexcom sensor as an alternative for glucose monitoring.

Topics: Acrylates; Adhesives; Adult; Blood Glucose Self-Monitoring; Camphanes; Child; Dermatitis, Allergic Contact; Diabetes Mellitus; Female; Humans; Male; Middle Aged

Topics: Acrylates; Allergens; Camphanes; Diabetes Mellitus; Humans; Wearable Electronic Devices