The Use of Thermography for Studying Diabetic Foot Complication through the Alteration of Thermoregulation Mechanism

The aim of the present study was to characterize thermoregulatory mechanism in the feet depending on the lower limb diabetes complication (i.e., diabetic foot neuropathy, peripheral arterial disease or both) using a thermal camera. A transversal study was conducted to analyse the effect of diabetes complication on thermoregulation mechanism. This study was approved by the Hospital of Lapeyronie (Montpellier, France, clinical trials NCT03872089). 51 participants were enrolled, among these participants 8 were subjects without diabetes and 43 were subjects with diabetes mellitus. Among them, 10 were diagnosed with a peripheral neuropathy (PN), 4 with a peripheral arterial disease (PAD), 8 with both complication (PN-PAD) and 23 without these specific complication (DM). Enrolled participants were placed barefoot in a semi-Fowler’s position in a room at 25°C controlled temperature during 5 min, enabling thermal acclimation. A first 10 min thermal recording of both plantar foot sole was done, acting as baseline, then they were asked to perform the 6-min walking test. It was assumed that thermoregulation activation would occur during exercise or during the hyperaemia phase (post-exercise). Finally, subjects were then recorded for a further 10 min, just after the exercise period. In each case, foot skin temperature oscillations were under interest. Evaluation of results before the 6-minute walk exercise revealed poorer difference, it seems crucial to activate thermoregulation mechanism before any interpretation. Finally, we found that it was possible to distinguish the presence of PN, or PAD, among diabetic subjects. It seems also possible to scale the severity of the complication. In conclusion, alteration of thermoregulatory mechanism amplitude is associated with presence of PN or PAD. Thermal camera may give valuable information to the practitioner, allowing the latter one of having accurate information about the complication, linked to the DF, for each patient. Disclosure V. Serantoni: None. F. Jourdan: None. H. Louche: None. A. Sultan: None. Funding LabEx NUMEV (2011-LABX-076)