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Skin temperature in the neuropathic diabetic foot
E J Boyko1, J H Ahroni, V L Stensel
1General Internal Medicine Section and Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA. eboyko@u.washington.edu
Journal of Diabetes and Its Complications
|August 28, 2001
Summary
Diabetic veterans with sensory neuropathy had lower foot skin temperature. Autonomic neuropathy showed no direct link, but a greater blood pressure drop was linked to lower foot temperatures.
Area of Science:
- Endocrinology
- Neurology
- Vascular Medicine
Background:
- Diabetic neuropathy is a common complication affecting veterans.
- Previous studies suggested elevated foot skin temperature in diabetic individuals with autonomic neuropathy.
- The association between neuropathy and foot temperature requires further investigation in diverse populations.
Purpose of the Study:
- To re-examine the association between sensory and autonomic neuropathy and foot skin temperature in diabetic veterans.
- To investigate the relationship between specific neuropathy indicators and foot temperature.
- To identify potential confounding factors influencing foot temperature in diabetes.
Main Methods:
- Cross-sectional study of 712 veterans with diabetes mellitus.
- Sensory neuropathy assessed via 5.07 monofilament testing.
- Autonomic neuropathy evaluated using cardiovascular reflex tests.
- Infrared surface scanning measured foot skin temperature.
- Multiple linear regression analysis adjusted for confounding factors.
Main Results:
- Subjects with sensory neuropathy exhibited lower mean plantar foot skin temperature (28.4°C vs. 28.9°C, P=.0101).
- Autonomic neuropathy as a dichotomous variable was not associated with foot skin temperature.
- Foot skin temperature negatively correlated with orthostatic systolic blood pressure drop (r=-.08, P=.0385), a marker of autonomic neuropathy.
- This association remained significant for the right foot after adjustments.
Conclusions:
- Diabetic veterans with sensory or autonomic neuropathy do not present with higher foot skin temperature.
- Results suggest a potential inverse relationship between foot skin temperature and orthostatic blood pressure fall.
- Other factors likely contribute to observed differences in foot temperature among diabetic patients.