Reducing Diabetic Foot Ulcers with Temperature Monitoring

April 7, 2017

Diabetic foot ulcers (DFU) are lesions of the skin of the foot that affects 15% of people with diabetes during their lifetime.¹ Chronic non-healing foot ulcers precedes about 85% of the lower extremity amputations in people who have diabetes.² The risk factors for DFU are:

  • Peripheral neuropathy (motor, sensory and autonomic): loss of pain, pressure awareness, foot deformities and reduced sweating;
  • Peripheral arterial disease: reduces blood flow and wound healing;
  • History of previous ulcers and amputations.³

According to the international working group on the diabetic foot (IWGDF) guidance on the prevention of foot ulcers in at-risk patients with diabetes there is moderate evidence for monitoring foot skin temperature at home to prevent first or recurrent plantar foot ulcer. Foot skin temperature monitoring helps to identify early signs of inflammation.4

Mobility induces friction (shear stress) which causes the foot to heat up due to inflammation and enzymatic breakdown of tissue, before the precipitation of an ulcer.5 Three randomized controlled trials (Table 1) conducted by the same research group showed that corrective action taken in response to a 4°F difference in contralateral plantar foot skin temperature measured using handheld infrared thermometer prevented first or recurrent foot ulcers in patients with a history of ulcer and/or sensory neuropathy and foot deformity by three to ten fold.

“Foot skin temperature monitoring helps to identify early signs of inflammation.”

Fewer subjects (2.4%) in the enhanced therapy group developed ulcers compared to subjects in the standard therapy group (16%, P

“Diabetic socks not only provide protection, but also continuously monitor foot temperature and send the information to a smartphone application.”


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The temperature information received seamlessly can be used to take preventive self care actions or shared with a treating physician or podiatrist.  For patients with diabetes who are obese, have limited hip and knee mobility or impaired visual acuity conducting self examination might be cumbersome and a wearable temperature monitoring socks would help them prevent foot ulcers through constant monitoring and feedback.

About the author

Tanu Bose has a passion for developing patient-centered products and programs which improve clinical outcomes and quality of life. She has led clinical development, partnerships, product development, and program management at various organizations. She earned her Ph.D. from the University of Texas and an MBA from UCLA Anderson School of Management.

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