Good Hygiene Can Prevent Infections in Patients with Diabetes

Maintaining proper skincare hygiene can help in preventing infections when using diabetes devices.

Practicing and maintaining proper hygiene can be very crucial in preventing infections. Patients with diabetes usually deal with lots of devices daily. Therefore, it is imperative to support those devices’ cleanliness to keep your skin healthy. Sometimes, those devices can malfunction, and patients have to make sure they will not cause any problems for their skin. The skin is usually considered a protective barrier, but is also a specialized organ that aids in the delivery of drug molecules into the body. The four most common types of skin issues patients usually experience while wearing these devices: contact dermatitis, allergic contact dermatitis, lipohypertrophy, and lipoatrophy. Our goal is to find solutions to alleviate the patient’s concern with these devices.

Contact dermatitis, also known as hypersensitivity type 1, is a red and itchy rash that is usually not contagious but very uncomfortable. With this condition, patients can also experience edematous, bruised skin, and hyper or hypopigmentation. This condition happens from continuously using glucose monitor sensors, insulin patch pumps, and medical tape. When these are removed, a part of the epidermis layer is also removed. Adhesive tapes can trap bacteria and moisture, which can lead to more skin damage. Allergic contact dermatitis, known as hypersensitivity type 4, is another skin issue that patients experience. Allergic contact dermatitis can occur from adhesive tapes that contain acrylate monomers. It will cause erythema and hives or skin erosions. In addition, using the insulin patches daily in the same area can cause lipohypertrophy, a fat accumulation underneath the skin surface. These patients will notice raised areas on their skin. Other patients may experience lipoatrophy, a loss of fat tissue from insulin therapy.

Patients with diabetes who are continually using these devices should check their skin areas regularly. They need to notice raised or inflamed areas. Using the devices properly is crucial because it can avoid an infection in the long run. Diabetes educators have a vital duty to demonstrate the correct procedure for removing and placing devices in the skin to keep it clean and healthy. Before placing a device in the skin, the patient should shower and wait until that area is dry and cool. It is also essential to wash the hands with soap and water before touching any products. The devices should be placed in areas with a flat skin surface. They should not be placed in skin areas with scars, tattoos, moles, or stretch marks. Also, patients with diabetes should limit the use of additional adhesive tapes that can trap more bacteria, and a proper adhesive remover should be used on those occasions. It is essential to read the small brochures or labels that the manufacturers provide before using or inserting them into the skin. If a patient is aware of getting skin allergies, it is crucial to use a different device or patch that will not cause any allergies.

This study is critical because we are surrounded by many devices, patches, and adhesive tapes in the healthcare industry. Understanding the right way to use them can prevent an infection from occurring. One way to prevent that from happening is for diabetes educators to use the teach-back method with their patients. After the educators have demonstrated adequately how to use that product, then it is the patients’ turn to show how to use it. In addition, maintaining good hygiene by washing hands and body before using a device is the best way to prevent infection in patients with diabetes.

Practice Pearls:

• Maintaining good hygiene and skin care can prevent infections while using diabetes devices.
• The most common skin issues that patients with diabetes experience from these devices, insulin patches, and adhesive tapes include: contact dermatitis, allergic contact dermatitis, and lipohypertrophy or lipoatrophy.
• Diabetes educators have a crucial role in educating and demonstrating the proper technique to use these devices.

Michael Monostra. “Skincare essentials to preventing infections while using diabetes devices.” Healio, August 8 2020. Web. August 19, 2020.   https://www.healio.com/news/endocrinology/20200817/skin-care-essential-to-preventing-infections-while-using-diabetes-devices

Parhi, Rabinarayan, and Aishwarya Mandru. “Enhancement of skin permeability with thermal ablation techniques: concept to commercial products.” Drug delivery and translational research, 1–25. July 21. 2020. Web. August 19, 2020.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372979/

Joan Prifti, PharmD. Candidate, LECOM College of Pharmacy