Elapsed Time After Infusion Set Removal Modulates Skin Barrier Integrity

Title
Elapsed time after infusion set removal modulates skin barrier integrity.
Introduction
Eczema and wounds are common complications associated with diabetes devices such as insulin pumps and glucose sensors, which adhere directly to the skin. Removal of patches during infusion set (IS) or sensor changes may impair the skin barrier through skin stripping. Repeated stripping due to insufficient site rotation may contribute to eczema and wound de-velopment.
Objectives
To investigate skin barrier integrity at baseline comparing frequent and infrequent IS changes, using clinical examination, ultrasound, and electrical impedance spectroscopy. Impedance spectroscopy provided an artificial measure of skin barrier strength.
Methods
Eighty participants aged 7–17 years using the Medtronic MiniMed 780G AID system were included from an ongoing randomized controlled trial. Participants used either a 3-day or 7-day IS. Frequency of change was determined based on median wear time. Continuous glu-cose monitoring (CGM) and pump data from the preceding 60 days were uploaded.
Results
At baseline, 51 participants used a 3-day IS and 29 a 7-day IS. Median wear time was 3.5 days for 3-day IS users and 5.1 days for 7-day IS users. Unless otherwise stated, results refer to the most recent IS site. The average number of days since IS removal at the time of investigation is presented in the table.
For clinical and ultrasound findings, see table 1.

Electrical impedance spectroscopy measured skin barrier integrity across three different skin sites. The scale ranges from 0-5, where lower values indicate a stronger skin barrier.
Values with 95% CI: control site 1.1 (0.9;1.2), latest site 2.9 (2.7;3.2), second-latest 2.3 (2.0;2.6).
Conclusions
Electrical impedance spectroscopy shows promise for evaluating skin barrier integri-ty at IS sites, revealing diminished function following device use. While only mini-mal baseline differences in skin health or glycemic control were observed between groups, full trial results may reveal clinically meaningful distinctions.