High Diagnostic Yield of Testing With a Diabetes Device Screening Series in Patients With Suspected Allergic Reactions to Glucose Sensors, Insulin Patch Pumps and Insulin Infusion Sets

BACKGROUND: Patch testing in patients with dermatitis from diabetes devices is challenging because device composition is nearly always undisclosed, relevant allergens are incompletely known, and many suspected allergens are not commercially available. OBJECTIVES: To evaluate the diagnostic yield of a dedicated diabetes device screening series, supplemented with a (meth)acrylate series and testing of patients' own device adhesives and adhesive extracts, in patients with suspected allergic contact dermatitis to glucose sensors, insulin patch pumps, or infusion sets. MATERIALS AND METHODS: We performed a retrospective patch test study of 100 patients referred to a tertiary referral centre for suspected allergic reactions to diabetes devices. RESULTS: Seventy-one patients reacted to one or more allergens in the diabetes device screening series; in 50 (70.4%), at least one reaction was clinically relevant. The most frequent relevant allergens were colophonium and its related substances abietic acid and hydroabietyl alcohol, isobornyl acrylate, dicyclohexylmethane-4,4'-diisocyanate, and N,N-dimethylacrylamide. The (meth)acrylate series had no clear additional diagnostic value. Testing with patients' own device adhesives and extracts frequently identified allergic reactions to devices not recognised by the results of the screening series alone. CONCLUSION: The combined approach identified relevant contact allergies in most patients with suspected allergic contact dermatitis to diabetes devices.