Patch Testing in Individuals With Diabetes Using Medical Devices. Part 2—Contact Allergy to Medical Device Allergens and New Patch Test Recommendations

BACKGROUND: Previous studies on contact allergy to diabetes medical devices (MDs) are based on patients referred for patch testing due to suspected allergic contact dermatitis. OBJECTIVES: To present real-world data on contact allergy to MD allergens among diabetes MD users. To suggest a MD patch test series. METHODS: Adults with type 1 diabetes using diabetes MDs followed up at two endocrinology departments were invited to be patch tested with a novel MD patch test series. RESULTS: Of the 204 participants (114 with skin rash to diabetes MDs, 90 without), 16.2% were positive to allergens found in diabetes MDs. The prevalence was significantly higher in those with skin rash to diabetes MDs versus without (28.1% vs. 1.1%; adjusted p-value < 0.001). For allergens found in diabetes MDs, the highest contact allergy rates were seen to isobornyl acrylate (10.3%), N,N-dimethylacrylamide (4.9%), 2-hydroxyethyl acrylate (3.4%), and dicyclohexylmethane-4,4'-diisocyanate (2.9%). CONCLUSIONS: Among diabetes MD users, the prevalence of contact allergy to MD allergens was remarkably high. 2-hydroxyethyl acrylate has not previously been reported as a culprit allergen in diabetes MDs, which underlines the importance of repeated chemical analyses and continuous update of the MD series. A better prevention of MD-related contact allergies is called for.