Measuring Dermal Temperature Helps Diabetics Keep Their Feet

Diabetics can now use the wand-like, gooseneck TempTouch before they begin their day’s activities. A spike in temperature warns that an infection is brewing so they can stay off their feet until the threat of an ulcer subsides.

Dr. David Armstrong, director of the Scholl College Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University of Medicine and Science and the James A. Lovell Federal Health Center in North Chicago, Ill., together with other leading podiatrists hope “dermal thermometry” becomes a norm in treatment of the diabetic foot.
William Buchanan takes his temperature every morning, but he doesn’t hold a thermometer under his tongue. He holds it to the bottom of his feet.

The 76-year-old has Type II diabetes and has subsequently lost sensation in his feet. He uses the TempTouch to help prevent ulcers that could lead to amputation.

Two years ago, Buchanan, who lives in Queens, was shopping with his wife when he took a spill in a parking lot. “I got up and walked to the car, no problem,” he said. “The next morning I used ‘the wand‘ and there was a big difference in readings between my right and left foot.”  An X-ray revealed that Buchanan had broken his left toe.

“If I didn’t have that wand to check with, I would have walked around for a couple weeks without feeling it and I would have wound up with an infection,” Buchanan said. “And then I would have had a big problem – off with the leg.”

Clinical trials, including one that will be published in December in the American Journal of Medicine, are proving that skin temperature monitoring significantly reduces foot ulcers in diabetics who suffer neuropathy – numbness in their extremities.

Dr. David Armstrong, director of the Scholl College Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University of Medicine and Science and the James A. Lovell Federal Health Center in North Chicago, Ill., was principal investigator and lead author on the latest study using the infrared TempTouch.

Diabetics can now use the wand-like, gooseneck TempTouch before they begin their day’s activities. A spike in temperature warns that an infection is brewing so they can stay off their feet until the threat of an ulcer subsides.

“A wound will heat up before the skin breaks down,” said Armstrong, professor of surgery and associate dean at Rosalind Franklin’s Scholl College of Podiatric Medicine. “You can detect infection by checking one foot compared to another foot, one toe compared to another toe.”

Problems with feet account for about one-third of all hospital admissions for people with diabetes, according to Armstrong who lectures around the world on treatment of the diabetic foot and ways to prevent amputations.

The latest clinical trial found that study participants who used the TempTouch were three times less likely to develop ulcers compared to those in the standard therapy group who were instructed on how to visually inspect their feet.

Armstrong insists many people with diabetes have trouble examining their feet and that only between 10 and 20 percent ask their doctor to do so during routine check-ups.  “Many can’t reach their feet,” Armstrong said. “Many have retinopathy – they can’t see well. And the diabetic foot doesn’t bother them. They have lost ‘the gift’ of pain.”

Diabetic ulcers, can cost $14,000 per patient to treat in the first year.

Armstrong and other leading podiatrists hope “dermal thermometry” becomes a norm in treatment of the diabetic foot. “Three separate federally-funded trials suggest it works,“ Armstrong said.

More people with diabetics will begin using hand-held devices like the TempTouch, which costs $150, as they become easier to use and cheaper to manufacture and as more insurers reimburse for them, said Dr. James Christina, director of scientific affairs for the American Podiatric Medical Association.  But while insurance companies pay lip service to preventive care, they are often reluctant to make the up-front investment.

“We still have challenges with getting insurance companies to pay for prevention visits to podiatrists in some cases,” Christina said. “That’s a big problem. Preventive care can be so cost effective. Studies show a whole-team approach to helping diabetics take care of their feet can help prevent ulcerations and amputations.”

https://www.rosalindfranklin.edu and https://www.lifeindiscovery.com.
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Arch Intern Med. 2007;167(22):2461-2468 and 2453-2460.