Diabetic Foot Ulcers

Monitoring skin temperature of the foot at home may be an effective method of preventing foot complications in patients at high risk for lower-extremity ulceration and amputation. In a recent study published in Diabetes Care, Lawrence A. Lavery, DPM, MPH, of Texas A&M Health Science Center, Temple, TX, and colleagues evaluated the effectiveness of at-home infrared temperature monitoring to prevent diabetes-related ulcers and foot complications.

The study included 85 patients who had neuropathy and foot deformity or a history of ulceration or partial foot amputation. Study subjects were randomized into a standard or an enhanced therapy group. Those in the standard therapy group wore therapeutic footwear, received diabetic foot education, and were evaluated regularly by a podiatrist.

Subjects in the enhanced therapy group received the same treatment, with the addition of a handheld infrared skin thermometer to measure temperatures on the sole of the foot in the morning and the evening. Patients with elevated foot temperatures, defined as more than 4[degrees] F above the opposite foot's temperature, were considered at risk for ulceration.

Subjects were followed for 6 months and were instructed to reduce their activity and contact the study nurse when foot temperatures were elevated. Those in the enhanced therapy group were found to have significantly fewer complications (P = .01). Only 1 ulcer developed in the enhanced therapy group, compared with 7 ulcers and 2 Charcot fractures in the standard therapy group.

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