American Diabetes Association
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A Skin Care Program to Prevent Skin Problems due to Diabetes Devices in Children and Adolescents: A Cluster-Controlled Intervention Study

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posted on 2023-07-21, 18:46 authored by Anna Korsgaard Berg, Annemarie Cecilie Grauslund, Fiona Sørensen, Steffen Ullitz Thorsen, Jacob P. Thyssen, Claus Zachariae, Jannet Svensson

Objective: Diabetes devices that deliver insulin and measure blood glucose are cornerstones in modern treatment of type 1 diabetes. However, their use is frequently associated with the development of skin problems, particularly eczema and wounds. Proper skin care may prevent skin problems, yet evidence-based information from interventional studies is missing, which therefore is the aim of this study.

Research Design and Methods: This first cluster-controlled intervention study tested the efficacy of a basic skin care program (including use of lipid cream, removal, and avoidance of disinfection). A total of 170 children and adolescents with type 1 diabetes were included and assigned either to the intervention group (n=112) or the control group (n=58). Participants were seen quarterly the first year after device initiation with clinical assessment and interview in an unblinded setting. 

Results: Eczema or wounds were observed in 33.6% of the intervention group compared to 46.6% of control participants with absolute difference of 12.9% [95% CI: -28.7%;2.9%], p = 0.10. The adjusted odds of wounds were decreased by 71% in the intervention compared to control group – odds ratio for wounds of 0.29 [95% CI: 0.12;0.68], p = 0.005. In total, only eight infections were seen without a higher frequency in the intervention group despite advice of omitting disinfection. 

Conclusions: These data indicate our basic skin care program partially prevented diabetes device-induced skin reactions. However, further preventive strategies with other adhesives, patches and/or types of lotions are still needed for optimized prevention. 


This study was financially supported by a research grant from the Danish Diabetes Academy, which is funded by the Novo Nordisk Foundation, grant number NNF17SA0031406, Aase and Ejnar Danielsens Grant, The medical grant from University of Copenhagen, Aage Bangs Dermatological Grant, Holms Fund of memory, a scholarship from the Research Board of Herlev and Gentofte Hospital and an external research program from Medtronic, but without Medtronic having any influence on data collection, analyses, or reports. All Decubal ® 70% Lipid Cream was supplied from TEVA Pharma, but without TEVA having any influence on data collection, analysis, or reports.


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