Background: Use of a continuous glucose-monitoring system (CGMS) in the management of type 1 diabetes (T1D) may cause local skin irritation.
Objective: To examine the clinical and metabolic effect of fluticasone propionate aqueous nasal solution (nsFP) , sprayed topically on the skin area prior to CGMS insertion.
Subjects: All patients treated in one center, who experienced skin irritation due to CGMS device and adhesives, who were offered this management.
Methods: This is a case-series observational report, including real life 6 months follow up data. Primary outcome; the difference in degree of skin irritation before and after use, according to the modified Draize scale. Secondary outcome; the change in BMI SDS, height SDS, mean glucose, and HbA1c after nsFP administration.
Results: The series included12 participants, mean age 8.6 ± 4.9 years, 66.7% males. Two patients had no improvement. Ten patients, median age 6.1 (5.3, 9.5), 56% males, demonstrated a positive response, with resolution of the local skin reaction. All were using the spray for a mean duration of 0.56 ± 0.11 years. No statistically significant differences were found in HbA1c 7.9(7.5,8.1) vs. 7.4(7-7.9), mean glucose 180(153,202) vs. 165(150-192), and number of daily prick tests 8.9(5.8,11.1) vs. 10.1 (8.9,13.5). BMI-SDS was non-significantly higher at the end of follow up 0.03(-0.22,0.93) vs. 0.44(-0.9,1),p=0.05.
Conclusions: The simple use of an aqueous topical steroid spray on the skin may safely improve tolerance to CGMS devices in children and adolescents experiencing local reactions to the adhesives. Regular BMI assessment is recommended.
