title: Frequency of dermatological side effects of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes.
abstract: BACKGROUND
  The incidence of type 1 diabetes is rising, particularly in young infants. The treatment with continuous subcutaneous insulin infusion (CSII) offers certain benefits and has gained popularity. Insulin-pump therapy could be associated with cutaneous-adverse effects. The purpose of our study was to investigate the frequency and characterization of skin-related complications in patients with CSII.
  
  
  METHODS
  In a single center setting, 54 patients (28 male, 26 female) on CSII therapy aged between 3 and 20 years participated in our study. Data including duration of diabetes, duration of CSII, pump model, catheter material, frequency of catheter switch and hygiene procedures at time of puncture were collected through a standardized questionnaire and photographs of affected areas of the skin were made. Statistical analysis was done to verify an association with gender, patients' age, HbA1c values, and body mass index.
  
  
  RESULTS
  Our observation revealed skin complications at the site of catheter insertion in 43% (8 f, 15 m) of our patients. A frequent occurrence of scars (24%, 6 f, 7 m), lipohypertrophic areas (20%, 4 f, 7 m) and eczema (11%, 1 f, 5 m) was observed. Furthermore, 6% (1 f, 2 m) showed changes in pigmentation and 6% (1 f, 2 m) lipoatrophy. The catheter localization had to be switched due to skin-complications in 24% (6 f, 7 m) whereas none of our patients discontinued insulin-pump therapy.
  
  
  CONCLUSIONS
  Skin-related complications during CSII are frequent and regular examination of the insertion sites is crucial. To verify the occurrence of lipoatrophy associated with insulin pump therapy - an otherwise rare complication - larger studies would be needed.
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck.
authors.forename: E
authors.initials: E
authors.lastname: Binder
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck.
authors.forename: O
authors.initials: O
authors.lastname: Lange
authors.affiliation: Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck.
authors.forename: M
authors.initials: M
authors.lastname: Edlinger
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck.
authors.forename: D
authors.initials: D
authors.lastname: Meraner
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck.
authors.forename: D
authors.initials: D
authors.lastname: Abt
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck.
authors.forename: C
authors.initials: C
authors.lastname: Moser
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck.
authors.forename: E
authors.initials: E
authors.lastname: Steichen
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck.
authors.forename: S E
authors.initials: SE
authors.lastname: Hofer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000453:epidemiology* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004485:Eczema / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects*; D007332:Insulin Infusion Systems / Q000009:adverse effects*; D008297:Male; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin