[Thermal imaging properties of toes after walking stress test in diabetic patients]

In consecutive 50 diabetic patients hospitalized for medical education, without subjective symptoms of autonomic neuropathy (DM group), performed treadmill walking stress test and thermography, for clarify the feature of the pattern typical of diabetic autonomic neuropathy. Thermal images were collected, before, immediately after, 3, 6, 12 minutes after walking. The mean temperature of toes fell more than 1 degree C than that of baseline level and returned within 0.5 degrees C of baseline level within 6 minutes (N type) in 66% of 30 normal subjects (C group) and 24% of DM group. In 10% of C and 24% of DM, the temperature fell but not returned within 0.5 degrees C of baseline level in 6 minutes (D type). In 17% of C and 38% of DM, the temperature changed within 0.5 degrees C (F type), or rose more than 0.5 degrees C after exercise (U type) in 7% in C and 14% in DM groups. Pts D, F group, have more complications (HbA1c, nephropathy, retinopathy or somatic neuropathy), but not so in C, U type. We concluded D, F types were the typical thermographic features of the toes of pts with diabetic autonomic neuropathy.