“Out of the box” solution for skin problems due to glucose-monitoring technology in youth with type 1 diabetes: real-life experience with fluticasone spray

  • Michal Paret
  • Galia Barash
  • Marianna RachmielEmail author
Original Article



Use of a continuous glucose-monitoring system (CGMS) in the management of type 1 diabetes (T1D) may cause local skin irritation.


To examine the effects of fluticasone propionate aqueous nasal solution (nsFP), sprayed topically prior to CGMS insertion among youth with T1D.


This is a case series observational report, including real-life 6-month follow-up data from one pediatric diabetes center. All patients suffering from local skin irritation due to CGMS adhesives were offered prevention form skin irritation by spraying 2 puffs of nsFP on the skin area prior to adhesion of CGMS. Data were collected from their charts after 6 months. Outcome measures included the difference in degree of skin irritation, number of days of CGMS use, BMI SDS, mean glucose, and HbA1c, prior to use and during 6 months after use.


Twelve patients used nsFP prior to CGMS insertion, mean age 8.6 ± 4.9 years and 66.7% males. Ten patients, median age 6.1 years (5.3–9.5) and 56% males, continued using nsFP for a mean of 0.56 ± 0.11 years, with no recurrence of local irritation nor dermatitis to same adhesive material. No differences were found before and after use of nsFP in CGMS mean glucose 180 mg/dl (153–202) versus 165 mg/dl (150–192). BMI SDS was slightly higher 0.44 (− 0.9–1.2) versus 0.25 (− 0.47–1.06), P = 0.05.


This small-scale, single-site description of a simple intervention by nsFP and favorable outcome provides valuable insight for a simple solution for skin irritation and dermatitis in the pediatric population with T1D.


Nasal spray Children Erythema Skin hypersensitivity 



Continuous glucose-monitoring system


Type 1 diabetes


Fluticasone propionate nasal spray


Continuous subcutaneous insulin infusion


Hemoglobin A1c, glycated hemoglobin



We would like to thank Itzik Ortasi, the father of one of our patients, who first introduced us to the option of using nsFP, Dr Tomer Ziv for the statistical analysis and Camille Vainstein for English-language editing.

Compliance with ethical standards

Conflict of interest

All authors have no conflict of interest.

Ethical approval

The study was conducted according to the Ethical tandards of care according to Helsinki and Human rights.

Informed consent

Informed consent procedure was performed according to institutional ethical review board of the study.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pediatric Endocrinology UnitAssaf Harofeh Medical CenterZerifinIsrael
  2. 2.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael

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