Prevalence and types of insulin-pump-related skin complications in children and adolescents with type 1 diabetes: A systematic review and meta-analysis.

This systematic review and meta-analysis synthesized evidence on the prevalence and types of diabetes technology-related skin complications in children and adolescents with type 1 diabetes. Thirteen primary studies were included in the systematic review. Five studies involving 796 children and adolescents contributed data to the primary meta-analysis of any skin complication. Using a random-effects model, the pooled prevalence was 63.8% (95% CI 47.8%-77.2%), with substantial heterogeneity (I2 = 92.1%). Among specific complications, the pooled prevalence was 36.7% for scarring/insertion marks, 24.1% for lipohypertrophy, 16.6% for eczema/dermatitis-like reactions, 8.6% for infection/folliculitis, and 5.1% for lipoatrophy. The findings indicate that skin complications are common among young users of insulin pumps and related diabetes technologies, but interpretation is limited by inconsistent definitions, outcome ascertainment, and heterogeneous outcome reporting. Future prospective studies using standardized outcome definitions and consistent skin-assessment methods are needed to clarify risk factors and guide regular skin assessment, site-rotation, and skin-care strategies in pediatric type 1 diabetes care.