Temperature check may prevent diabetic foot ulcer

Adding a daily check of foot temperature with an infrared skin thermometer to standard diabetic foot therapy can significantly reduce the recurrence of foot ulcers, doctors in Texas and Chicago report in the medical journal Diabetes Care.

The digital infrared thermometer, called TempTouch, costs approximately $150 and is powered by 9-V batteries, Don Lawson, CEO of the thermometer maker Xilas Medical, told Reuters Health.

Co-investigator Dr. Lawrence A. Lavery, at Texas A&M University Health Science Center in Temple, and his associates point out that elevated skin temperature is a sign of inflammation and tissue injury, but the signs may be too subtle to detect.

The team randomly assigned 173 diabetic patients between 18 and 80 years of age to one of three treatment groups for 15 months. One group received standard therapy, consisting of a foot evaluation every 8 weeks, therapeutic insoles and footwear, and an education program.

A second group received the same treatment, plus instructions to inspect the bottom of their feet with a mirror twice daily.

The enhanced therapy group received the same treatment as the second, but also used the TempTouch thermometer daily and were told to notify the study nurse if the temperature at the same site differed by more than 4° F.

About 30 percent of subjects in the first two groups developed a new foot ulcer, compared with only 8.5 percent in the third group. Ninety percent of the first two groups also had full-thickness ulcers by the time they noticed a problem.

"Once patients identify a hot spot, they are told to modify their activity and stay off their feet until the temperature normalizes," Lawson said, which is probably what reduced the ulcer rate.

SOURCE: Diabetes Care, January 2007.