O-47 Filaggrin mutations and dermatological complications due to diabetes devices

Introduction: Dermatological complications are a major obstacle for use of diabetes devices especially in children and adolescents. Filaggrin (FLG) mutations seen in 8% of the Danish population are associated with atopic dermatitis and skin barrier impairment.
Objectives: We aimed to investigate the association between FLG mutations and the risk of dermatological complications due to diabetes devices.
Methods: A prospective study of children and adolescents with type 1 diabetes followed the first year after initiation of diabetes devices with quarterly visits including visual examination of the skin and genotyping for the five most frequent mutations in FLG gene. All study participants (or caregivers) scored their perception of skin dryness at baseline on a scale from 0-100. Descriptive statistics, unpaired t-test, and two-proportions Z-test were used as statistics.
Results: Of 155 participants 13 (8.4%) had mutation in FLG (one homozygous and 12 heterozygous). The proportions of dermatological complications due to diabetes devices during follow-up are shown in Figure 1 separated by FLG mutation status. No significant differences were found for developing eczema, wound, scars or any reaction depending on FLG mutation. The proportions of eczema with FLG mutation were 2/13 (15%) vs. 43/141 (30%) in the wildtype (WT) group and for scars 5/13 (38%) in mutation (MUT) group compared with 28/141 (20%) in the WT group. The baseline perception of skin dryness showed mean ± standard deviation in MUT group of 63 ± 17 compared to 34 ± 26 in WT group (p-value from t-test: p < 0.001).
Conclusions: Having one of the most common FLG mutations are not proved associated with dermatological complications despite increased skin dryness. The relatively small study sample and having dry skin supports better skin care habits may contribute to the negative findings. Further research is needed in a bigger sample also including skin FLG expression data.