Temperature check prevents 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. Researchers form the Texas A&M University Health Science Center in Temple, USA, pointed out that elevated skin temperature is a sign of inflammation and tissue injury, but the signs may be too subtle to detect. They 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 programme. A second group received the same treatment, plus instructions to inspect the bottom of their feet with a mirror twice daily. The third enhanced therapy group received the same treatment as the second, but also used the skin thermometer daily and were told to notify the study nurse if the temperature at the same site differed by more than 4° F. It was found that 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 normalises, which is probably what reduced the ulcer rate.