Infrared Thermography and Vascular Disorders in Diabetic Feet

Abstract

Aim: Diabetes mellitus (DM) and related foot complications constitute a growing healthcare burden. Diabetes mellitus is associated with lower-limb amputation, but diabetic foot assessment is challenging. Here, we evaluated a novel noninvasive diagnostic method—infrared thermography (IRT) —assessing its diagnostic potential compared to conventional noninvasive measurements. Methods: This study included patients with DM ( n = 118) and healthy controls ( n = 93). All participants underwent ankle brachial index and toe pressure (TP) measurements, and IRT using a standardized protocol with temperature measurement at five foot areas. Results: Compared to controls, patients with DM generally had warmer feet and exhibited a significantly greater temperature difference between feet ( P < .001). Mean temperatures were highest in patients with DM with neuroischemia, followed by neuropathy. Patients with DM with angiopathy showed the lowest mean temperature—similar to controls and noncomplicated diabetics. Mean temperatures at all measurement sites were significantly higher with abnormal TP (<50 mmHg) than normal TP (≥50 mmHg) ( P < .001). Infrared thermography revealed differences between angiosome areas, subclinical infections, and plantar high-pressure areas. Conclusion: Infrared thermography revealed local temperature differences in high-risk diabetic feet. Normal skin surface temperature varies between individuals, but in combination with other tools, IRT might be useful in clinical screening. ClinicalTrials ID: 14212016