Home skin temperature monitoring
Use of an experimental home temperature monitoring instrument (FootScan; Salix Medical, San Antonio, TX) led to fewer foot complications in patients with diabetes compared with patients who did not use the device, according to 2 studies led by Lawrence A. Lavery, DPM, MPH.
Both single-blinded, randomized clinical trials evaluated the effectiveness of an infrared temperature home monitoring instrument (FootScan) to reduce the incidence of foot complications in high-risk patients with diabetes. In a 6-month, Phase I study, 85 subjects with diabetes were assigned to 2 groups: standard care (control group) and enhanced care. For a 15-month, Phase II study, 173 patients were randomized into 3 groups: standard care (control group), structured exam (subjects performed a structured foot inspection each day and recorded the results in a logbook), and enhanced care. All subjects received therapeutic footwear, diabetic foot education, and regular foot care (standard care); subjects in the treatment group used FootScan to measure temperatures on foot sites each day (enhanced care). Subjects in the enhanced care group were instructed to contact a nurse and reduce activity when the temperature difference between the left and right corresponding sites was greater than 4[degrees]F.
In the Phase I study, subjects in the enhanced care group had fewer foot complications compared with the subjects in the standard care group (2.4% vs 20.4%, respectively). The same was true of the Phase II study: 8.5% of subjects in the enhanced care group developed foot ulcers, compared with 27.6% in the standard care and 30.4% in the structured exam group.
The authors concluded that home temperature monitoring may be a useful adjunctive tool to a comprehensive prevention program for patients at risk for foot ulcers and amputations.
The Phase I study was presented at the annual meeting of the American Diabetes Association in June. The recently completed Phase II study results were presented at the annual meeting of the European Association for the Study of Diabetes in September.
Sources: Lavery LA, Higgins KR, Holguin D, Harkless LB, Armstrong DG. Home skin monitoring reduces the incidence of diabetic foot complications. Presented at and in abstract book: American Diabetes Association 62nd Scientific Sessions; June 14-18, 2002; San Francisco, CA. Abstract 75-ORLavery LA, Higgins KR, Armstrong DG, Holguin D, Athanasiou KA. Randomized clinical trial to evaluate a novel home temperature monitoring device to reduce the incidence of diabetic foot complications. Presented at: European Association for the Study of Diabetes annual meeting and on-line at http://www.easd.org; September 1-15, 2002; Budapest, Hungary. Poster 1058.