Thermographic quantitative variables for diabetic foot assessment: preliminary results

ABSTRACT The aim of this study was to define aspects of a protocol for a diabetic population by obtaining and evaluating thermographic images following thermal stress (cooling of the sole of the foot with cold gel) and mechanical stress (walking 100 m). A sample made up of 15 patients diagnosed as diabetic individuals and 7 healthy subjects as controls were analysed for this protocol. Following thermal stress, the recovery time of 90% of the basal foot temperature was (64 ± 43) s for control cases and (99 ± 98) s for diabetic cases (p < 0.02). With mechanical stress, a mean thermal variation of (−1.3 ± 1.1)◦C for control cases was obtained as against (−2.0 ± 1.1)◦C for diabetic cases (p < 0.001). The results obtained provide evidence that thermographic imaging can provide relevant information on vascularisation in patients and, therefore, can be a useful tool in the early diagnosis of diabetic foot disease.

[1]  Matthew J. Maley,et al.  Thermographic imaging in sports and exercise medicine: A Delphi study and consensus statement on the measurement of human skin temperature. , 2017, Journal of thermal biology.

[2]  G. Reiber,et al.  The Epidemiology of Diabetic Foot Problems , 1996, Diabetic medicine : a journal of the British Diabetic Association.

[3]  Jamal Ahmad,et al.  Diabetic foot ulcer--A review on pathophysiology, classification and microbial etiology. , 2015, Diabetes & metabolic syndrome.

[4]  D. Armstrong,et al.  Preventing foot ulcers in patients with diabetes. , 2005, JAMA.

[5]  R. Frantz,et al.  Wound Bioburden and Infection-Related Complications in Diabetic Foot Ulcers , 2008, Biological research for nursing.

[6]  S. Liatis,et al.  Moisture Status of the Skin of the Feet Assessed by the Visual Test Neuropad Correlates With Foot Ulceration in Diabetes , 2010, Diabetes Care.

[7]  J. Richard,et al.  [Epidemiology of diabetic foot problems]. , 2008, La Revue de medecine interne.

[8]  Caroline Cabral Robinson,et al.  Repeatability of Infrared Plantar Thermography in Diabetes Patients: A Pilot Study , 2013, Journal of diabetes science and technology.

[9]  Manuel Sillero Quintana,et al.  Time required to stabilize thermographic images at rest , 2014 .

[10]  B. B. Lahiri,et al.  Infrared Thermography for Detection of Diabetic Neuropathy and Vascular Disorder , 2017 .

[11]  J. Berger,et al.  Diabetes mellitus is a coronary heart disease risk equivalent for peripheral vascular disease , 2017, American heart journal.

[12]  D G Smith,et al.  Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. , 1999, Diabetes care.

[13]  Rob Simpson,et al.  Thermal symmetry of healthy feet: a precursor to a thermal study of diabetic feet prior to skin breakdown , 2017, Physiological measurement.

[14]  F. Soriguer,et al.  [Evolution of prevalence of type 2 diabetes in adult Spanish population]. , 2007, Medicina clinica.

[15]  Samuel Sideman,et al.  Dynamic Thermography: Analysis of Hand Temperature During Exercise , 1998, Annals of Biomedical Engineering.

[16]  Pedro Pérez-Soriano,et al.  Definition of the thermographic regions of interest in cycling by using a factor analysis , 2016 .

[17]  G. Rojo-Martínez,et al.  Evolución de la prevalencia de la diabetes tipo 2 en población adulta española , 2007 .

[18]  Hylton B Menz,et al.  Normative values for the Foot Posture Index , 2008, Journal of foot and ankle research.

[19]  J. I. P. Quesada,et al.  Infrared Thermography Protocol for the Diagnosis and Monitoring of the Diabetic Foot: Preliminary Results , 2017 .

[20]  J. Steketee.  Spectral emissivity of skin and pericardium. , 1973, Physics in medicine and biology.

[21]  Rosario Salvador Palmer,et al.  Physics Principles of the Infrared Thermography and Human Thermoregulation , 2017 .

[22]  L. Lavery,et al.  Mortality of first-time amputees in diabetics: a 10-year observation. , 2009, Diabetes research and clinical practice.

[23]  Dan Ziegler,et al.  Diabetic neuropathies: a statement by the American Diabetes Association. , 2005, Diabetes care.

[24]  A. Izenberg,et al.  Diabetic Neuropathies , 2015, Seminars in Neurology.

[25]  F. Carpes,et al.  Plantar pressure and foot temperature responses to acute barefoot and shod running , 2015 .

[26]  L. Kuller,et al.  The ratio of ankle and arm arterial pressure as an independent predictor of mortality. , 1991, Atherosclerosis.

[27]  Caroline Cabral Robinson,et al.  Plantar thermography is useful in the early diagnosis of diabetic neuropathy , 2012, Clinics.