A comparison between the foot dermal temperatures in patients living with controlled diabetes mellitus type 2 and patients living with diabetes mellitus type 2 and suffering from charcot neuroarthropathy

Abstract

Background: One of the lesser studied complications of diabetes mellitus and peripheral neuropathy is Charcot neuroarthropathy. A lack of diagnostic criteria and specific markers unfortunately lead to late or undiagnosed cases of this condition. Thermographic imaging is an emerging field in healthcare and has been used in multiple studies about the diabetic foot. It is ideal due to being remote, contactless and non-invasive. Aim: The aim of this study was to investigate if there was a difference in dermal temperatures in the feet of patients living with controlled Diabetes Mellitus Type 2 and patients living with Diabetes Mellitus Type 2 and suffering from Charcot neuroarthropathy using thermographic imaging. Research design and method A non-experimental comparative study was held at the Biomechanics laboratory at the Faculty of Health Sciences at Mater Dei Hospital. Patients with controlled type 2 diabetes and patients with type 2 diabetes and Charcot Neuroarthropathy were enrolled in this comparative study. A thermographic image of the plantar aspect of the participants’ feet was taken with an infrared thermographic camera after an acclimatisation period of 15 minutes. During the acclimatisation period, the patients’ demographic data was noted. After the thermographic image was captured, the Charcot Neuroarthropathy group of patients underwent a vascular and neurological assessment. Results There was no significant difference in dermal temperatures in the feet of patients living with controlled Diabetes Mellitus Type 2 and patients living with Diabetes Mellitus Type 2 and suffering from Charcot neuroarthropathy, thus answering the research question. A significant difference in dermal temperatures was found in the medial and lateral midfoot sections of the affected Charcot Neuroarthropathy foot when compared to the unaffected foot, with the affected foot having a higher temperature. Conclusion: Although IR thermography is a promising modality in the screening of the diabetic foot, it should not be used as a stand-alone tool to predict diabetic foot complications but as an adjunct tool in the screening process. Further research still needs to be done especially in the field of Charcot Neuroarthropathy, in order to fully understand the condition, and its long-term effects with respect to foot temperatures in order to achieve the best possible outcome for patients.