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Preventing diabetic foot ulcer recurrence in high-risk patients: use of temperature monitoring as a self-assessment tool.
Diabetes Care. 2007 Jan; 30(1):14-20.DC

Abstract

OBJECTIVE

The purpose of this study was to evaluate the effectiveness of a temperature monitoring instrument to reduce the incidence of foot ulcers in individuals with diabetes who have a high risk for lower extremity complications.

RESEARCH DESIGN AND METHODS

In this physician-blinded, randomized, 15-month, multicenter trial, 173 subjects with a previous history of diabetic foot ulceration were assigned to standard therapy, structured foot examination, or enhanced therapy groups. Each group received therapeutic footwear, diabetic foot education, and regular foot care. Subjects in the structured foot examination group performed a structured foot inspection daily and recorded their findings in a logbook. If standard therapy or structured foot examinations identified any foot abnormalities, subjects were instructed to contact the study nurse immediately. Subjects in the enhanced therapy group used an infrared skin thermometer to measure temperatures on six foot sites each day. Temperature differences >4 degrees F (>2.2 degrees C) between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized.

RESULTS

The enhanced therapy group had fewer foot ulcers than the standard therapy and structured foot examination groups (enhanced therapy 8.5 vs. standard therapy 29.3%, P = 0.0046 and enhanced therapy vs. structured foot examination 30.4%, P = 0.0029). Patients in the standard therapy and structured foot examination groups were 4.37 and 4.71 times more likely to develop ulcers than patients in the enhanced therapy group.

CONCLUSIONS

Infrared temperature home monitoring, in serving as an "early warning sign," appears to be a simple and useful adjunct in the prevention of diabetic foot ulcerations.

Authors+Show Affiliations

Department of Surgery, Scott and White Hospital, Texas A&M University Health Science Center, Temple, Texas, USA. llavery@swmail.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17192326

Citation

Lavery, Lawrence A., et al. "Preventing Diabetic Foot Ulcer Recurrence in High-risk Patients: Use of Temperature Monitoring as a Self-assessment Tool." Diabetes Care, vol. 30, no. 1, 2007, pp. 14-20.
Lavery LA, Higgins KR, Lanctot DR, et al. Preventing diabetic foot ulcer recurrence in high-risk patients: use of temperature monitoring as a self-assessment tool. Diabetes Care. 2007;30(1):14-20.
Lavery, L. A., Higgins, K. R., Lanctot, D. R., Constantinides, G. P., Zamorano, R. G., Athanasiou, K. A., Armstrong, D. G., & Agrawal, C. M. (2007). Preventing diabetic foot ulcer recurrence in high-risk patients: use of temperature monitoring as a self-assessment tool. Diabetes Care, 30(1), 14-20.
Lavery LA, et al. Preventing Diabetic Foot Ulcer Recurrence in High-risk Patients: Use of Temperature Monitoring as a Self-assessment Tool. Diabetes Care. 2007;30(1):14-20. PubMed PMID: 17192326.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preventing diabetic foot ulcer recurrence in high-risk patients: use of temperature monitoring as a self-assessment tool. AU - Lavery,Lawrence A, AU - Higgins,Kevin R, AU - Lanctot,Dan R, AU - Constantinides,George P, AU - Zamorano,Ruben G, AU - Athanasiou,Kyriacos A, AU - Armstrong,David G, AU - Agrawal,C Mauli, PY - 2006/12/29/pubmed PY - 2007/3/7/medline PY - 2006/12/29/entrez SP - 14 EP - 20 JF - Diabetes care JO - Diabetes Care VL - 30 IS - 1 N2 - OBJECTIVE: The purpose of this study was to evaluate the effectiveness of a temperature monitoring instrument to reduce the incidence of foot ulcers in individuals with diabetes who have a high risk for lower extremity complications. RESEARCH DESIGN AND METHODS: In this physician-blinded, randomized, 15-month, multicenter trial, 173 subjects with a previous history of diabetic foot ulceration were assigned to standard therapy, structured foot examination, or enhanced therapy groups. Each group received therapeutic footwear, diabetic foot education, and regular foot care. Subjects in the structured foot examination group performed a structured foot inspection daily and recorded their findings in a logbook. If standard therapy or structured foot examinations identified any foot abnormalities, subjects were instructed to contact the study nurse immediately. Subjects in the enhanced therapy group used an infrared skin thermometer to measure temperatures on six foot sites each day. Temperature differences >4 degrees F (>2.2 degrees C) between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized. RESULTS: The enhanced therapy group had fewer foot ulcers than the standard therapy and structured foot examination groups (enhanced therapy 8.5 vs. standard therapy 29.3%, P = 0.0046 and enhanced therapy vs. structured foot examination 30.4%, P = 0.0029). Patients in the standard therapy and structured foot examination groups were 4.37 and 4.71 times more likely to develop ulcers than patients in the enhanced therapy group. CONCLUSIONS: Infrared temperature home monitoring, in serving as an "early warning sign," appears to be a simple and useful adjunct in the prevention of diabetic foot ulcerations. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/17192326/Preventing_diabetic_foot_ulcer_recurrence_in_high_risk_patients:_use_of_temperature_monitoring_as_a_self_assessment_tool_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=17192326 DB - PRIME DP - Unbound Medicine ER -