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Home Monitoring of Foot Skin Temperatures to Prevent Ulceration

LAVERY, Lawrence A ; HIGGINS, Kevin R ; LANCTOT, Dan R ; CONSTANTINIDES, George P ; ZAMORANO, Ruben G ; ARMSTRONG, David G ; ATHANASIOU, Kyriacos A ; AGRAWAL, C. Mauli

Diabetes care, 2004-11, Vol.27 (11), p.2642-2647 [Periódico revisado por pares]

Alexandria, VA: American Diabetes Association

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  • Título:
    Home Monitoring of Foot Skin Temperatures to Prevent Ulceration
  • Autor: LAVERY, Lawrence A ; HIGGINS, Kevin R ; LANCTOT, Dan R ; CONSTANTINIDES, George P ; ZAMORANO, Ruben G ; ARMSTRONG, David G ; ATHANASIOU, Kyriacos A ; AGRAWAL, C. Mauli
  • Assuntos: Amputation ; Biological and medical sciences ; Clinical outcomes ; Diabetes ; Diabetes Complications - prevention & control ; Diabetes Mellitus - therapy ; Diabetes. Impaired glucose tolerance ; Diabetic Foot - etiology ; Diabetic Foot - prevention & control ; Effectiveness studies ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Female ; Foot ; Foot Ulcer - prevention & control ; Humans ; Infrared Rays ; Male ; Medical Records ; Medical sciences ; Middle Aged ; Quality of Life ; Risk Factors ; Self Care ; Single-Blind Method ; Skin Temperature ; Thermometers
  • É parte de: Diabetes care, 2004-11, Vol.27 (11), p.2642-2647
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
    ObjectType-Feature-1
    ObjectType-News-3
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  • Descrição: Home Monitoring of Foot Skin Temperatures to Prevent Ulceration Lawrence A. Lavery , DPM, MPH 1 , Kevin R. Higgins , DPM 2 , Dan R. Lanctot , BS 2 , George P. Constantinides , MS 2 , Ruben G. Zamorano , MSW, MPH 2 , David G. Armstrong , DPM 3 , Kyriacos A. Athanasiou , PHD, PE 4 and C. Mauli Agrawal , PHD, PE 1 5 1 College of Medicine, Texas A&M Health Science Center, Scott and White Hospital, Temple, Texas 2 Xilas Medical, San Antonio, Texas 3 Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine, Chicago, Illinois 4 Department of Bioengineering, Rice University, Houston, Texas 5 Department of Biomedical Engineering, The University of Texas, San Antonio, Texas Address correspondence and reprint requests to Lawrence A. Lavery, 703 Highland Spring Ln., Georgetown, TX 78628. E-mail: llavery{at}swmail.sw.org Abstract OBJECTIVE —To evaluate the effectiveness of at-home infrared temperature monitoring as a preventative tool in individuals at high risk for diabetes-related lower-extremity ulceration and amputation. RESEARCH DESIGN AND METHODS —Eighty-five patients who fit diabetic foot risk category 2 or 3 (neuropathy and foot deformity or previous history of ulceration or partial foot amputation) were randomized into a standard therapy group ( n = 41) or an enhanced therapy group ( n = 44). Standard therapy consisted of therapeutic footwear, diabetic foot education, and regular foot evaluation by a podiatrist. Enhanced therapy included the addition of a handheld infrared skin thermometer to measure temperatures on the sole of the foot in the morning and evening. Elevated temperatures (>4°F compared with the opposite foot) were considered to be “at risk” of ulceration due to inflammation at the site of measurement. When foot temperatures were elevated, subjects were instructed to reduce their activity and contact the study nurse. Study subjects were followed for 6 months. RESULTS —The enhanced therapy group had significantly fewer diabetic foot complications (enhanced therapy group 2% vs. standard therapy group 20%, P = 0.01, odds ratio 10.3, 95% CI 1.2–85.3). There were seven ulcers and two Charcot fractures among standard therapy patients and one ulcer in the enhanced therapy group. CONCLUSIONS —These results suggest that at-home patient self-monitoring with daily foot temperatures may be an effective adjunctive tool to prevent foot complications in individuals at high risk for lower-extremity ulceration and amputation. VPT, vibratory perception threshold Footnotes L.A.L., D.G.A., and K.A.A. are paid consultants for, serve on an advisory board for, and hold stock in Xilas Medical. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted August 6, 2004. Received May 20, 2004. DIABETES CARE
  • Editor: Alexandria, VA: American Diabetes Association
  • Idioma: Inglês
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