Jan 19, 2007

Taking Foot Temperature Helps Prevent Ulcers

Tara Dairman

A new study reported in the January 2007 issue of the journal Diabetes Care showed that checking foot temperature daily with a special thermometer reduced the recurrence of foot ulcers in people with diabetes by a significant margin.

In the study, 173 people aged 18-80 who had diabetes and had previously had foot ulcers were divided into three groups. Members of the "standard therapy" group received therapeutic footwear, education on diabetic foot care, a foot evaluation from a doctor every eight weeks, and instructions to inspect their feet daily. Members of the "structured foot examination" group received the same therapy as the standard group and were also instructed to inspect their feet twice daily with a mirror and to record their findings in a logbook. Finally, members of the "enhanced therapy" group received the same treatment as the standard group but were also instructed to use an infrared skin thermometer to measure temperature at six foot sites each day and to record their findings. The doctors who treated participants did not know to which group they had been assigned.

Members of all three groups were told to contact the study nurse immediately if any abnormalities were found. Members of the enhanced therapy group were additionally told to reduce activity and contact the study nurse if they found temperature differences of more than 4°F between corresponding sites on their left and right feet.

When the study ended after 15 months, only 8.5% of people in the enhanced therapy group had developed a foot ulcer, compared to about 30% of people in both the standard therapy and structured foot examination groups. When the numbers were crunched, the researchers concluded that participants in the groups that had not used a skin thermometer were more than four times as likely to develop a foot ulcer as those who did use a skin thermometer.

This study built upon the results of a smaller study, published in Diabetes Care in 2004, that had also shown benefit for using an infrared skin thermometer to find "hot spots" on the feet. This previous study helped show that elevated skin temperature, a sign of inflammation, could be an early warning sign of tissue damage and foot ulceration. In both studies, when people who found "hot spots" on their feet reduced their activity and contacted a study nurse, they reduced their chances of developing a foot ulcer.

The thermometer used in the study is called the TempTouch and is manufactured by Xilas Medical, Inc. It costs approximately $150, and a prescription form is needed to purchase the device. More information and a prescription form are available at www.xilas.com.

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