Dermal Thermometry Helps Diabetics Keep Their Feet

Skin temperature monitoring significantly reduces foot ulcers in diabetics who suffer neuropathy (numbness in their extremities), according to a new study.

Researchers at Rosalind Franklin University (Chicago, IL, USA) conducted a physician-blinded, 18-month randomized controlled trial of 225 subjects with diabetes at high risk for ulceration. The patients were assigned to standard therapy or dermal thermometry groups. Both groups received therapeutic footwear, diabetic foot education, regular foot care, and performed a structured foot inspection daily. Dermal thermometry group subjects used an infrared skin thermometer--called TempTouch--to measure temperatures on six foot sites twice daily. Temperature differences of more than four degrees Farenheit between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized.

The researchers found that a total of 8.4% of the subjects ulcerated over the study period. Subjects were one third as likely to ulcerate in the dermal thermometry group compared with the standard therapy group. Proportional hazards regression analysis suggested that thermometry intervention was associated with a significantly longer time to ulceration, adjusted for elevated foot ulcer classification, age, and minority status. Patients that ulcerated had a temperature difference that was 4.8 times greater at the site of ulceration in the week before ulceration than did a random 7 consecutive-day sample of 50 other subjects that did not ulcerate. The study was published in the December 2007 issue of the American Journal of Medicine.

"A wound will heat up before the skin breaks down,” said lead author Dr. David Armstrong, a professor of surgery and director of the Scholl College Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University. "You can detect infection by checking one foot compared to another foot, one toe compared to another toe.”

The infrared TempTouch, manufactured by Xilas Medical (San Antonio, TX, USA) is a wand-like, gooseneck thermometer that diabetics use before they begin their day's activities. A spike in temperature warns that an infection is brewing so they can stay off their feet until the threat of an ulcer subsides.


Related Links:
Rosalind Franklin University
Xilas Medical