CD09 Assessment of diabetic glucose monitors using gas chromatography–mass spectroscopy

Abstract

Allergy to diabetic devices, particularly acrylates and colophonium derivatives, is a growing problem. There is a paucity of literature on the constituents of the devices currently on the market, which makes it difficult to advise patients and their physicians. We have previously reported our experience in patch testing patients with reactions to a variety of devices (Sexton F, O’Mahony J, Sumera S et al. Culprit allergens in diabetes technology-­associated allergic contact dermatitis: investigation remains challenging. Br J Dermatol 2025; 193: 792–4). Dendooven et al. have recently reported analysis of several devices used in the Netherlands (Dendooven E, Haentjens F, Kanokrungsee S et al. 1,6-Hexanediol diacrylate, isocyanates and other skin sensitizers are emerging contact allergens in guardian glucose sensors. Contact Dermatitis 2025; 93: 514–26). The aim of this study was to analyse devices used in Ireland in 2025 and their significance for our patients. A validated gas chromatography–mass spectrometry method was developed for the targeted semiquantitative analysis of known acrylates, Myroxylon pereirae constituents and colophonium derivatives, while untargeted analysis enabled the screening of additional potentially relevant allergens. Components of wearable diabetes devices (e.g. sensors and overpatches) were extracted in acetone containing an internal standard. Multiple extraction procedures were tested and compared. As with previous methods, we detected benzyl alcohol, methyl dehydroabietate and isobornyl acrylate (IBOA) in some, or all, of the devices tested. We also detected several potential sensitizers including linalool, isopropyl myristate, tert-butylphenol and isopropyl palmitate. We have confirmed the work of others in detecting colophonium derivatives and IBOA. A number of new allergens have also been identified including linalool, isopropyl myristate, tert-butylphenol and isopropyl palmitate. The presence of a variety of adhesive agents is expected. The presence of fragrance allergens has been highlighted previously and may relate to colophonium. As far as we are aware, this is the first report of the presence of linalool, isopropyl myristate, tert-butylphenol and isopropyl palmitate in diabetic devices and may have implications for patients for the future.