Toward Safer Diabetes Devices: GC–MS Detection of Allergens in Sensors, Pumps, and Infusion Sets

Diagnostic patch testing in patients with suspected allergic contact dermatitis from glucose sensors, insulin pumps, and infusion sets is hampered by a lack of information on the chemical composition of these diabetes devices. To identify chemicals present in diabetes devices that may bring about this allergic contact, a joint study between Amsterdam University Medical Centers and MEDLAB analyzed over two dozen glucose sensors, insulin pumps, and insulin infusion sets to identify the chemicals present in these devices using gas chromatography–mass spectrometry (GC–MS). A paper based on their research was published in Contact Dermatitis (1).

An itchy rash caused by direct contact with a substance or an allergic reaction to it, contact dermatitis, while not contagious, can be very uncomfortable for the patient (2). Skin complications related to the use of glucose sensors and insulin pumps are common regardless of age (3,4). While the precise incidence and prevalence of allergic contact dermatitis (ACD) remains unknown, 45%–60% of patients referred to university hospitals for suspected ACD are diagnosed with allergic reactions to their diabetes devices (5,6).

For this study, 40 acetone extracts of 27 devices (10 sensors, 3 patch pumps, 12 infusion sets and 2 single adhesives) were investigated with GC-MS. The technique identified 284 individual chemicals. All 40 extracts contained one or more chemicals that were previously identified as allergens in diabetes devices causing allergic Contact Dermatitis. Fourteen of 27 devices (52%) contained one or more acrylates, 8 (30%) colophonium derivatives, all 27 (100%) one or two phenolic allergens (2,4-di-tert-butylphenol, p-tert-butylphenol, butylated hydroxytoluene), and 9 (33%) 1-hydroxycyclohexyl phenyl ketone. None of the other chemicals except bisphenol A were well-known haptens; that hapten was present in half of the extracts, in some cases in very high concentrations (1).

“One of the aims of our study,” the authors of the paper wrote, “was to identify chemicals which may act as undetected allergens in these diabetes devices. With the exception of the chemicals already known to be sensitizers, not one of the 284 chemicals found in the extracts is an established and frequent allergen. Yet, contact allergy to bisphenol A, which was found to be present in our investigation in half of the extracts and sometimes at very high concentrations, has been observed repeatedly. Therefore, we consider bisphenol A as a chemical of interest and have added it (1% pet.) to our diabetes device screening series.” (1)

The data compiled from this study “can help dermatologists establish the relevance of positive patch tests observed in patients with allergic reactions to one or more of the 27 products investigated.” In addition, they believe that the information can equally assist in choosing safer alternatives for patients in whom device-related allergens have been demonstrated. However, whether the chemicals that show very low concentrations in the extracts can and will induce ACD in individual sensitized patients cannot reliably be predicted (1).

Read More on Similar Topics:

Advancing Health and Disease Research with Efficient Analytical Methods

Determining the Effectiveness and Safety of Cinnamon Derivatives for Diabetes Treatment with HPLC

References

1. van Oers, E. M.; de Groot, A. C.; Verolme, P. et al. Results of GC-MS Analyses of 40 Extracts of Diabetes Devices. Contact Dermatitis 2025, DOI: 10.1111/cod.70052
2. Contact dermatitis.Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/contact-dermatitis/symptoms-causes/syc-20352742 (accessed 2025-12-01)
3. Berg, A. K.; Passanisi, S.; von dem Berge, T. et al. SKIN-PEDIC: A Worldwide Assessment of Skin Problems in Children and Adolescents Using Diabetes Devices. Horm. Res. Paediatr. 2025, 1-14. DOI: 10.1159/000545428
4. Ulriksdotter, J.; Sukakul, T.; Bruze, M. et al. A Cross-Sectional Study Demonstrating a High Prevalence of Skin Rash to Diabetes Medical Devices: An Underestimated Problem. J. Diabetes Sci. Technol. 2025,19322968251336261. DOI: 10.1177/19322968251336261
5. von Kobyletzki, L. B.; Ulriksdotter, J.; Sukakul, T. et al. Prevalence of Dermatitis Including Allergic Contact Dermatitis from Medical Devices Used by Children and Adults with Type 1 Diabetes Mellitus: A Systematic Review and Questionnaire Study. J. Eur. Acad. Dermatol. Venereol. 2024, 38 (7), 1329-1346. DOI: 10.1111/jdv.19908
6. von Kobyletzki, L. B.; Ulriksdotter, J.; von Kobyletzki, E. et al. Insulin Pump Therapy and Adverse Skin Reactions With Focus on Allergic Contact Dermatitis in Individuals Living With Diabetes Mellitus: A Systematic Review and Clinical-Based Update. J. Diabetes Sci. Technol. 2024, 18 (6), 1300-1312. DOI: 10.1177/19322968241252613