Carro Gabriela Verónica, Noli María Laura, Rodriguez María Gabriela, Ticona Miguel, Fuentes Mariana, Llanos María de Los Ángeles, Caporaso Federico, Marciales Guillermo, Turco Sebastián Leandro Emanuel
Diabetic Foot Unit, Hospital Nacional Prof A. Posadas. El Palomar, Argentina.
Int J Low Extrem Wounds. 2023 Dec 19:15347346231218034. doi: 10.1177/15347346231218034.
Diabetic foot (DF) is one of the most devastating complications of diabetes mellitus (DM). Infrared thermography has been studied for its potential in early diagnosis and preventive measures against DF ulcers, although its role in the management and prevention of DF complications remains uncertain. The objective of this study was to determine the average temperatures of different points of the plantar foot using infrared thermography in patients with DM and history of DF (DFa group, at the highest risk of developing foot ulcers) and compare them to people without DM (NoDM group). One hundred and twenty-three feet were included, 63 of them belonged to DFa Group and the other 60 to NoDM Group. The average temperature in the NoDM Group was 27.4 (26.3-28.5) versus 28.6 (26.8-30.3) in the DFa Group ( = .002). There were differences between both groups in temperatures at the metatarsal heads and heels, but not in the arch. Average foot temperatures did not relate to sex, ankle-brachial index, and age, and had a mild correlation with daily temperature (Spearman 0.51, < .001). Data provided in our study could be useful in establishing a parameter of normal temperatures for high-risk patients. This could serve as a foundational framework for future research and provide reference values, not only for preventative purposes, as commonly addressed in most studies, but also to assess the applicability of thermography in clinical scenarios particularly when one foot cannot serve as a reference, suspected osteomyelitis of the remaining bone, or instances of increased temperature in specific areas which may necessitate adjustments to the insoles in secondary prevention.
糖尿病足（DF）是糖尿病（DM）最具破坏性的并发症之一。红外热成像技术因其在DF溃疡早期诊断和预防措施方面的潜力而受到研究，尽管其在DF并发症管理和预防中的作用仍不明确。本研究的目的是使用红外热成像技术测定患有DM且有DF病史（DFa组，发生足部溃疡风险最高）患者足底不同部位的平均温度，并将其与无DM的人群（NoDM组）进行比较。共纳入123只脚，其中63只属于DFa组，另外60只属于NoDM组。NoDM组的平均温度为27.4（26.3 - 28.5），而DFa组为28.6（26.8 - 30.3）（P = 0.002）。两组在跖骨头和足跟处的温度存在差异，但在足弓处无差异。足部平均温度与性别、踝肱指数和年龄无关，与每日温度有轻度相关性（Spearman相关系数0.51，P < 0.001）。我们研究中提供的数据可能有助于为高危患者建立正常温度参数。这可为未来研究提供基础框架并提供参考值，不仅用于大多数研究中常见的预防目的，还可用于评估热成像在临床场景中的适用性，特别是当一只脚不能作为对照、怀疑剩余骨头有骨髓炎或特定区域温度升高可能需要在二级预防中调整鞋垫时。
