Dermatological complications of continuous subcutaneous insulin infusion in children and adolescents

Conwell, Louise S., Pope, Elena, Artiles, Ana M., Mohanta, Arun, Daneman, Alan and Daneman, Denis (2008) Dermatological complications of continuous subcutaneous insulin infusion in children and adolescents. Journal of Pediatrics, 152 5: 622-628. doi:10.1016/j.jpeds.2007.10.006


Author Conwell, Louise S.
Pope, Elena
Artiles, Ana M.
Mohanta, Arun
Daneman, Alan
Daneman, Denis
Title Dermatological complications of continuous subcutaneous insulin infusion in children and adolescents
Journal name Journal of Pediatrics   Check publisher's open access policy
ISSN 0022-3476
1097-6833
1085-8695
Publication date 2008-05
Sub-type Article (original research)
DOI 10.1016/j.jpeds.2007.10.006
Volume 152
Issue 5
Start page 622
End page 628
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Abstract Objectives To describe the dermatological changes associated with continuous subcutaneous insulin infusion (CSII) therapy in youth with type 1 diabetes mellitus (T1D). To assess their association with duration of CSII, age, adiposity, HbA1c, insulin dose, insulin brand, infusion set or site. Study design We conducted a cross-sectional study of 50 consecutive patients with T1D who were using CSII for >6 months (26 female; age, 13.3 ± 3.5 years [mean ± SD]; CSII duration, 2.8 ± 1.7 years; HbA1c, 7.7% ± 1.1%). A grading scale was devised. Ultrasound scanning was performed in 8 subjects. Results The mean (±SD) severity score was 6.3 ± 3.5 (range, 0-14; maximum possible, 69). Most common were scars <3 mm diameter (94%), erythema not associated with nodules (66%), subcutaneous nodules (62%), and lipohypertrophy (42%). There was a significant negative correlation between severity score and body mass index z-score (r = −0.3, P = .039), but no correlation with HbA1c, insulin brand or site. Infusion sets inserted at 90° were associated with lower scores (P = .03). Less than 5% of patients and parents considered stopping CSII because of skin concerns. Ultrasound scanning results of CSII sites revealed mild increased echogenicity of the dermis and hypodermis. Conclusions Dermatological changes were frequent, with increased severity associated with lower adiposity. These complications were not associated with glycemic control, nor did they prompt most to consider stopping CSII.
Keyword DEPENDENT DIABETES-MELLITUS
PUMP THERAPY
INTENSIVE TREATMENT
YOUNG-CHILDREN
LISPRO INSULIN
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 07 Dec 2010, 09:30:42 EST