Checking foot temperature may curb diabetic sores

Patients with diabetes who are high risk for developing leg and foot ulcers - and the infection and amputation that can result - may be able to ward off these complications by monitoring their foot skin temperatures at home, a new study suggests.

As described in the medical journal diabetes Care, Dr. Lawrence A. Lavery of Texas A&M Health Science Center, in Temple, and colleagues examined the effectiveness of at-home infrared temperature monitoring in 85 at-risk patients.

Forty-one participants were assigned to a standard therapy group and were given therapeutic footwear, diabetic foot education, and regular foot evaluations by a podiatrist.

Forty-four subjects were placed in an enhanced therapy group in which they received standard care plus a handheld infrared skin thermometer to measure temperatures on the sole of the affected foot in the morning and evening.

If elevated temperatures were detected - greater than 4 degrees F compared to the other foot - the patients were considered at risk of ulceration and were instructed to reduce their activity and contact the study nurse.

The participants were followed for 6 months, during which time nine foot complications were seen in the standard therapy group, compared with one complication in the enhanced therapy group.

Infections developed in two patients in the standard therapy group and local foot amputations were performed. In contrast, no infections or amputations occurred in the enhanced therapy group, Lavery's team reports.

They realize that the results might have come from enhanced vigilance among subjects given the thermometer, and say they look forward to further studies of this approach.

If its value is confirmed, "thermometers may be used to allow patients to dose their activity ... just as many dose their insulin by checking their blood glucose," the researchers write.

SOURCE: Diabetes Care, November 2004.