Evaluation of Insulin Pump Infusion Sites in Type 1 Diabetes: The DERMIS Study
Authors' conclusion
These findings support allergic sensitization as a potentially common reaction at CSII sites. The leading candidates causing this include insulin preservatives, plastic materials, and adhesive glue used in device manufacturing. The inflammatory response caused by these common allergic responses may result in tissue changes responsible for the infusion site failures seen frequently in clinical practice.
Study context
- Population
- People with T1D using continuous subcutaneous insulin infusion (CSII)
- Exposure
- Insulin pump infusion sites vs control site
- Outcome
- Skin changes at pump sites (OCT, OCTA, histology, immunohistochemistry)
Main finding
As reported in the abstract
- Optical coherence tomography (OCT) and OCT angiography (OCTA): increased inflammation and vessel density at pump sites vs control sites
- Histology of pump sites: differences in skin architecture, incl. fibrosis, inflammation (incl. increased tissue eosinophils) and fat necrosis
- Immunohistochemistry: differences between infusion and control sites in staining of ILGF-I and transforming growth factor-β3
Observational data: associations, not effects.
Original publication
Evaluation of Insulin Pump Infusion Sites in Type 1 Diabetes: The DERMIS Study. Diabetes Care. Published 14 July 2023. doi:10.
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