Contact allergy to the Dexcom G6 glucose monitoring system-Role of 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate in the new adhesive

Contact Dermatitis. 2022 Sep;87(3):258-264. doi: 10.1111/cod.14141. Epub 2022 May 19.

Abstract

Background: Skin reactions to the glucose monitoring systems Dexcom G5 and G6 have been rare. In 2019, the components of the adhesive were exchanged for better skin fixation. Since then, more and more patients experienced severe skin reactions. A few months ago, 2,2'-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate (MBPA) was identified as a new component in the adhesive of the G6 model. Furthermore, it was suspected that isobornyl acrylate (IBOA) was also a component of the exchanged adhesive.

Objectives: Our objective was to investigate if MBPA plays a major role in the increasing skin problems of patients without a history of IBOA-sensitization. Furthermore, our aim was to examine whether IBOA is contained in the newer model adhesive and may also contribute to allergic contact dermatitis (ACD).

Patients and methods: Five patients with a newly occurred ACD caused by the glucose monitoring system Dexcom G6 were investigated. Patch testing including MBPA in three different concentrations, as well as IBOA, were performed. Gas chromatography-mass spectrometry of the newer system Dexcom G6 was carried out.

Results: All patients were shown to be sensitized to MBPA, while MBPA 0,5% showed the strongest reaction. On the other hand, IBOA was tested negative.

Conclusion: In our study group, MBPA was observed to be the triggering allergen of the recently changed adhesive.

Keywords: 2,2′-methylenebis(6-tert-butyl-4-methylphenol) monoacrylate; Dexcom; Freestyle Libre; acrylate; allergic contact dermatitis; continuous glucose monitoring systems; isobornyl acrylate; patch test.

MeSH terms

  • Acrylates / adverse effects
  • Adhesives / adverse effects
  • Adhesives / chemistry
  • Blood Glucose
  • Blood Glucose Self-Monitoring / adverse effects
  • Cresols
  • Dermatitis, Allergic Contact* / diagnosis
  • Dermatitis, Allergic Contact* / etiology
  • Glucose
  • Humans
  • Patch Tests / adverse effects
  • Phenols / adverse effects

Substances

  • Acrylates
  • Adhesives
  • Blood Glucose
  • Cresols
  • Phenols
  • 4-cresol
  • Glucose