TY - JOUR

T1 - The identification of higher forefoot temperatures associated with peripheral arterial disease in type 2 diabetes mellitus as detected by thermography

AU - Gatt, Alfred

AU - Sturgeon, Cassandra

PY - 2018/8/31

Y1 - 2018/8/31

N2 - AimsThe purpose of this study was to investigate whether heat emitted from the feet of patients with type 2 diabetes (DM) and peripheral arterial disease (PAD) differed from those with type 2 diabetes without complications (DM).MethodsA non-experimental, comparative prospective study design was employed in a tertiary referral hospital. Out of 223 randomly selected participants (430 limbs) who were initially tested, 62 limbs were categorized as DM + PAD and 22 limbs as DM without PAD. Subjects with evidence of peripheral neuropathy were excluded. Participants underwent thermographic imaging. Automatic segmentation of regions of interest extracted the temperature data.ResultsA significant difference in temperature in all the toes between the two groups was found (p = 0.005, p = 0.033, p = 0.015, p = 0.038 and p = 0.02 for toes 1–5 respectively). The mean forefoot temperature in DM + PAD was significantly higher than that in DM (p = .019), with DM + PAD having a higher mean temperature (28.3 °C) compared to DM (26.2 °C). Similarly, the toes of subjects with DM + PAD were significantly warmer than those of subjects with DM only.ConclusionsContrary to expectations the mean toe and forefoot temperatures in DM patients with PAD is higher than in those with DM only. This unexpected result could be attributed to disruption of noradrenergic vasoconstrictor thermoregulatory mechanisms with resulting increased flow through cutaneous vessels and subsequent increased heat emissivity. These results demonstrate that thermography may have potential in detecting PAD and associated temperature differences.

AB - AimsThe purpose of this study was to investigate whether heat emitted from the feet of patients with type 2 diabetes (DM) and peripheral arterial disease (PAD) differed from those with type 2 diabetes without complications (DM).MethodsA non-experimental, comparative prospective study design was employed in a tertiary referral hospital. Out of 223 randomly selected participants (430 limbs) who were initially tested, 62 limbs were categorized as DM + PAD and 22 limbs as DM without PAD. Subjects with evidence of peripheral neuropathy were excluded. Participants underwent thermographic imaging. Automatic segmentation of regions of interest extracted the temperature data.ResultsA significant difference in temperature in all the toes between the two groups was found (p = 0.005, p = 0.033, p = 0.015, p = 0.038 and p = 0.02 for toes 1–5 respectively). The mean forefoot temperature in DM + PAD was significantly higher than that in DM (p = .019), with DM + PAD having a higher mean temperature (28.3 °C) compared to DM (26.2 °C). Similarly, the toes of subjects with DM + PAD were significantly warmer than those of subjects with DM only.ConclusionsContrary to expectations the mean toe and forefoot temperatures in DM patients with PAD is higher than in those with DM only. This unexpected result could be attributed to disruption of noradrenergic vasoconstrictor thermoregulatory mechanisms with resulting increased flow through cutaneous vessels and subsequent increased heat emissivity. These results demonstrate that thermography may have potential in detecting PAD and associated temperature differences.

U2 - 10.1016/j.pcd.2018.01.001

DO - 10.1016/j.pcd.2018.01.001

M3 - Journal article

VL - 12

SP - 312

EP - 318

JO - Primary Care Diabetes

JF - Primary Care Diabetes

SN - 1751-9918

IS - 4

ER -