Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany.
Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany.
EBioMedicine. 2020 Apr;54:102712. doi: 10.1016/j.ebiom.2020.102712. Epub 2020 Apr 15.
Microcirculatory defects in diabetes are linked with neuropathy and the onset of diabetic foot syndrome. In this study we quantify pressure- and posture-dependent changes of plantar temperatures as a surrogate of tissue perfusion in healthy volunteers versus diabetes patients diagnosed with neuropathy in the absence of macroangiopathy.
Healthy volunteers (n = 31) as well as patients with diabetes diagnosed with severe polyneuropathy (n = 30) were enrolled in a clinical study to test for plantar temperature changes in the feet during extended episodes of standing. These lasted between 5 and 20 min each over 95 min, in between the participants were asked to take a seated position for 5 min and release the pressure from the feet. Major macroangiopathy was excluded before study enrolment. Custom-made insoles harbored temperature and pressure sensors positioned at eight preselected positions for recording.
In both subgroups a significant plantar temperature downshift occurred within 10 min of standing, which was especially detected during the initial 45 min of the study protocol. Comparisons between healthy volunteers and patients with diabetes revealed no differences in the magnitude of temperature downshifts during stance episodes. Pressure sensor recordings revealed that healthy volunteers intermittently released pressure during the longer stance episodes due to discomfort, whereas the patients with diabetes and polyneuropathy did not.
Our findings demonstrate a tight plantar temperature regulation following pressure exposure. In patients with diabetes and peripheral sensoric neuropathy the temperature drop is similar to healthy volunteers. Potentially, prolonged stance periods resulting in less perfused plantar tissue may remain unrecognized with polyneuropathy, whereas discomfort develops in healthy controls.
The study was supported by EFRE Förderung der Europäischen Union und Landesmittel des Ministeriums für Wirtschaft, Wissenschaft und Digitalisierung Sachsen-Anhalt (Vorhabennummer: ZS/2016/05/78,615 and ZS/2018/12/95,325). JK and PRM were supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - project ID 97,850,925 - SFB854, AM by the Chinese Scholarship Council (CSC).
糖尿病患者的微循环缺陷与神经病变和糖尿病足综合征的发生有关。在这项研究中，我们定量测量了健康志愿者和患有糖尿病神经病变（无大血管病变）的患者在压力和姿势依赖性下足底温度的变化，以作为组织灌注的替代指标。
健康志愿者（n=31）和被诊断患有严重多发性神经病的糖尿病患者（n=30）参加了一项临床研究，以测试在长时间站立期间脚部的足底温度变化。这些站立时间每次持续 5 至 20 分钟，中间间隔 5 分钟让参与者坐下并释放脚部压力。在研究入组前排除了主要的大血管疾病。定制的鞋垫上有温度和压力传感器，放置在八个预选位置进行记录。
在两个亚组中，站立 10 分钟内足底温度明显下降，尤其是在研究方案的最初 45 分钟内。将健康志愿者与糖尿病患者进行比较，发现站立期间的温度下降幅度没有差异。压力传感器记录显示，健康志愿者在较长的站立期间因不适而间歇性地释放压力，而患有糖尿病和多发性神经病的患者则没有。
我们的研究结果表明，在暴露于压力后，足底温度会受到紧密调节。患有糖尿病和周围感觉神经病变的患者的温度下降与健康志愿者相似。可能的是，由于神经病变，长时间站立导致灌注不足的足底组织可能未被识别，而在健康对照组中则会出现不适。
该研究得到了欧洲区域发展基金（EFRE）和萨克森-安哈尔特州经济、科学和数字化部（项目编号：ZS/2016/05/78,615 和 ZS/2018/12/95,325）的支持。JK 和 PRM 得到了德国研究基金会（DFG）的项目 ID 97,850,925 - SFB854 的支持，AM 得到了中国国家留学基金委员会（CSC）的支持。
