Measuring Skin Temperature Reduces Foot Problems

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Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients, by David G. Armstrong and colleagues. American Journal of Medicine 120:1042–1046, 2007

What is the problem and what is known about it so far?

Foot problems are common in people with diabetes. Nerve damage, one of the major complications of diabetes, can lead to loss of feeling in the feet. People with nerve damage might not realize they have a foot problem until an open wound develops. All people with diabetes are advised to inspect their feet every day for signs of injury.

Why did researchers do this particular study?

The researchers wanted to find out if having patients use a special thermometer to test their foot temperature at home would help prevent foot sores.

Who was studied?

The study included 225 U.S veterans with type 2 diabetes who were at high risk for developing foot sores.

How was the study done?

Patients were assigned to one of two groups. Both groups were taught about diabetes and foot problems, received protective footwear, and performed daily foot inspections. One group received standard foot care and was told to contact the study nurse if they had any foot problems.

The other group, in addition to standard care, measured the skin temperature at six places on their feet twice a day. These patients were told to contact the study nurse if they found temperature differences of more than 4 degrees between the same sites on their right and left foot. They were also told to reduce their activity until the temperatures became normal again. All patients’ feet were examined at the start of the study and then every 3 months for 18 months.

What did the researchers find?

Patients who measured their foot temperatures were far less likely to get foot sores than those who did not. For those who did get sores, noticeable temperature increases at the site of the sore could be found in the week before the sore developed.

What were the limitations of the study?

The researchers made some technical errors related to the number of patients they enrolled who had had previous foot sores or amputations versus the number who had had only nerve damage and loss of feeling. However, the number and type of patients were still enough to show meaningful results.

What are the implications of the study?

Self-monitoring foot temperature at home may help high-risk patients with diabetes identify problems early and reduce their risk of getting foot sores.

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