Foot temperature as a predictor of ulcers in Diabetes Mellitus
Abstract
The Diabetic Foot is one of the most important complications of Diabetes Mellitus due to the possibility of suffering a plantar ulcer that leads to an amputation.
Diabetic peripheral neuropathy occurs in 60-70 % of subjects with Diabetes Mellitus and is characterized by a disturbance of tactile and painful sensitivity, the alteration of the threshold of vibration and thermal perception for temperature thresholds to heat and cold.
The temperature of the feet of subjects with Diabetes Mellitus without diabetic peripheral neuropathy is lower than with the presence of diabetic peripheral neuropathy. There is a correlation between the increase in temperature and the appearance of lesions on the feet, because the temperature increases in the areas of risk of ulceration due to the inflammation itself and to the enzymatic autolysis of the tissues, prior to the appearance of a ulceration of Charcot arthropathy.
RESULTS: Currently, two types of temperature measurement techniques are used: thermography and thermometry. Thermography tests are classified into thermo sensitive infrared liquid crystal plates, and the thermometry tests are divided into infrared and thermal sensors.
The thermal assessment should be included in the neurological examination protocols of the feet in Diabetes Mellitus because it is an effective, non-invasive test and decreases the rate of ulcer appearance.
CONCLUSIONS: It is considered that a difference of 2.2º C, in the same point of both because of a subject, indicates the appearance of own injuries of the Diabetic Foot, either an ulceration if there is an injury, or a Charcot arthropathy.
Scientific evidence indicates that controlling the temperature of the feet decreases the rate of ulcerations in Diabetes Mellitus. We advocate the inclusion of thermal assessment in the protocol of exploration of subjects with Diabetes Mellitus, due to its effectiveness in the prevention of ulcerations and its short time of screening.
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