Preventing diabetic foot ulcer recurrence in high-risk patients: Use of temperature monitoring as a self-assessment tool

Lawrence A. Lavery, Kevin R. Higgins, Dan R. Lanctot, George P. Constantinides, Ruben G. Zamorano, Kyriacos A. Athanasiou, David G. Armstrong, C. Mauli Agrawal

Research output: Contribution to journalArticle

196 Citations (Scopus)

Abstract

OBJECTIVE - The purpose of this study was to evaluate the effectiveness of a temperature monitoring instrument to reduce the incidence of foot ulcers in individuals with diabetes who have a high risk for lower extremity complications. RESEARCH DESIGN AND METHODS - In this physician-blinded, randomized, 15-month, multicenter trial, 173 subjects with a previous history of diabetic foot ulceration were assigned to standard therapy, structured foot examination, or enhanced therapy groups. Each group received therapeutic footwear, diabetic foot education, and regular foot care. Subjects in the structured foot examination group performed a structured foot inspection daily and recorded their findings in a logbook. If standard therapy or structured foot examinations identified any foot abnormalities, subjects were instructed to contact the study nurse immediately. Subjects in the enhanced therapy group used an infrared skin thermometer to measure temperatures on six foot sites each day. Temperature differences >4°F (>2.2°C) between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized. RESULTS - The enhanced therapy group had fewer foot ulcers than the standard therapy and structured foot examination groups (enhanced therapy 8.5 vs. standard therapy 29.3%, P = 0.0046 and enhanced therapy vs. structured foot examination 30.4%, P = 0.0029). Patients in the standard therapy and structured foot examination groups were 4.37 and 4.71 times more likely to develop ulcers than patients in the enhanced therapy group. CONCLUSIONS - Infrared temperature home monitoring, in serving as an "early warning sign," appears to be a simple and useful adjunct in the prevention of diabetic foot ulcerations.

Original languageEnglish (US)
Pages (from-to)14-20
Number of pages7
JournalDiabetes Care
Volume30
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

Fingerprint

Diabetic Foot
Foot
Recurrence
Temperature
Group Psychotherapy
Foot Ulcer
Therapeutics
Nurses
Thermometers
Self-Assessment
Multicenter Studies
Ulcer
Lower Extremity
Research Design
Physicians
Education
Skin
Incidence

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Lavery, L. A., Higgins, K. R., Lanctot, D. R., Constantinides, G. P., Zamorano, R. G., Athanasiou, K. A., ... Agrawal, C. M. (2007). Preventing diabetic foot ulcer recurrence in high-risk patients: Use of temperature monitoring as a self-assessment tool. Diabetes Care, 30(1), 14-20. https://doi.org/10.2337/dc06-1600

Preventing diabetic foot ulcer recurrence in high-risk patients : Use of temperature monitoring as a self-assessment tool. / Lavery, Lawrence A.; Higgins, Kevin R.; Lanctot, Dan R.; Constantinides, George P.; Zamorano, Ruben G.; Athanasiou, Kyriacos A.; Armstrong, David G.; Agrawal, C. Mauli.

In: Diabetes Care, Vol. 30, No. 1, 01.2007, p. 14-20.

Research output: Contribution to journalArticle

Lavery, LA, Higgins, KR, Lanctot, DR, Constantinides, GP, Zamorano, RG, Athanasiou, KA, Armstrong, DG & Agrawal, CM 2007, 'Preventing diabetic foot ulcer recurrence in high-risk patients: Use of temperature monitoring as a self-assessment tool', Diabetes Care, vol. 30, no. 1, pp. 14-20. https://doi.org/10.2337/dc06-1600
Lavery LA, Higgins KR, Lanctot DR, Constantinides GP, Zamorano RG, Athanasiou KA et al. Preventing diabetic foot ulcer recurrence in high-risk patients: Use of temperature monitoring as a self-assessment tool. Diabetes Care. 2007 Jan;30(1):14-20. https://doi.org/10.2337/dc06-1600
Lavery, Lawrence A. ; Higgins, Kevin R. ; Lanctot, Dan R. ; Constantinides, George P. ; Zamorano, Ruben G. ; Athanasiou, Kyriacos A. ; Armstrong, David G. ; Agrawal, C. Mauli. / Preventing diabetic foot ulcer recurrence in high-risk patients : Use of temperature monitoring as a self-assessment tool. In: Diabetes Care. 2007 ; Vol. 30, No. 1. pp. 14-20.
@article{62ddd8afb5d04898bae4394c34ee1b52,
title = "Preventing diabetic foot ulcer recurrence in high-risk patients: Use of temperature monitoring as a self-assessment tool",
abstract = "OBJECTIVE - The purpose of this study was to evaluate the effectiveness of a temperature monitoring instrument to reduce the incidence of foot ulcers in individuals with diabetes who have a high risk for lower extremity complications. RESEARCH DESIGN AND METHODS - In this physician-blinded, randomized, 15-month, multicenter trial, 173 subjects with a previous history of diabetic foot ulceration were assigned to standard therapy, structured foot examination, or enhanced therapy groups. Each group received therapeutic footwear, diabetic foot education, and regular foot care. Subjects in the structured foot examination group performed a structured foot inspection daily and recorded their findings in a logbook. If standard therapy or structured foot examinations identified any foot abnormalities, subjects were instructed to contact the study nurse immediately. Subjects in the enhanced therapy group used an infrared skin thermometer to measure temperatures on six foot sites each day. Temperature differences >4°F (>2.2°C) between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized. RESULTS - The enhanced therapy group had fewer foot ulcers than the standard therapy and structured foot examination groups (enhanced therapy 8.5 vs. standard therapy 29.3{\%}, P = 0.0046 and enhanced therapy vs. structured foot examination 30.4{\%}, P = 0.0029). Patients in the standard therapy and structured foot examination groups were 4.37 and 4.71 times more likely to develop ulcers than patients in the enhanced therapy group. CONCLUSIONS - Infrared temperature home monitoring, in serving as an {"}early warning sign,{"} appears to be a simple and useful adjunct in the prevention of diabetic foot ulcerations.",
author = "Lavery, {Lawrence A.} and Higgins, {Kevin R.} and Lanctot, {Dan R.} and Constantinides, {George P.} and Zamorano, {Ruben G.} and Athanasiou, {Kyriacos A.} and Armstrong, {David G.} and Agrawal, {C. Mauli}",
year = "2007",
month = "1",
doi = "10.2337/dc06-1600",
language = "English (US)",
volume = "30",
pages = "14--20",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "1",

}

TY - JOUR

T1 - Preventing diabetic foot ulcer recurrence in high-risk patients

T2 - Use of temperature monitoring as a self-assessment tool

AU - Lavery, Lawrence A.

AU - Higgins, Kevin R.

AU - Lanctot, Dan R.

AU - Constantinides, George P.

AU - Zamorano, Ruben G.

AU - Athanasiou, Kyriacos A.

AU - Armstrong, David G.

AU - Agrawal, C. Mauli

PY - 2007/1

Y1 - 2007/1

N2 - OBJECTIVE - The purpose of this study was to evaluate the effectiveness of a temperature monitoring instrument to reduce the incidence of foot ulcers in individuals with diabetes who have a high risk for lower extremity complications. RESEARCH DESIGN AND METHODS - In this physician-blinded, randomized, 15-month, multicenter trial, 173 subjects with a previous history of diabetic foot ulceration were assigned to standard therapy, structured foot examination, or enhanced therapy groups. Each group received therapeutic footwear, diabetic foot education, and regular foot care. Subjects in the structured foot examination group performed a structured foot inspection daily and recorded their findings in a logbook. If standard therapy or structured foot examinations identified any foot abnormalities, subjects were instructed to contact the study nurse immediately. Subjects in the enhanced therapy group used an infrared skin thermometer to measure temperatures on six foot sites each day. Temperature differences >4°F (>2.2°C) between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized. RESULTS - The enhanced therapy group had fewer foot ulcers than the standard therapy and structured foot examination groups (enhanced therapy 8.5 vs. standard therapy 29.3%, P = 0.0046 and enhanced therapy vs. structured foot examination 30.4%, P = 0.0029). Patients in the standard therapy and structured foot examination groups were 4.37 and 4.71 times more likely to develop ulcers than patients in the enhanced therapy group. CONCLUSIONS - Infrared temperature home monitoring, in serving as an "early warning sign," appears to be a simple and useful adjunct in the prevention of diabetic foot ulcerations.

AB - OBJECTIVE - The purpose of this study was to evaluate the effectiveness of a temperature monitoring instrument to reduce the incidence of foot ulcers in individuals with diabetes who have a high risk for lower extremity complications. RESEARCH DESIGN AND METHODS - In this physician-blinded, randomized, 15-month, multicenter trial, 173 subjects with a previous history of diabetic foot ulceration were assigned to standard therapy, structured foot examination, or enhanced therapy groups. Each group received therapeutic footwear, diabetic foot education, and regular foot care. Subjects in the structured foot examination group performed a structured foot inspection daily and recorded their findings in a logbook. If standard therapy or structured foot examinations identified any foot abnormalities, subjects were instructed to contact the study nurse immediately. Subjects in the enhanced therapy group used an infrared skin thermometer to measure temperatures on six foot sites each day. Temperature differences >4°F (>2.2°C) between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized. RESULTS - The enhanced therapy group had fewer foot ulcers than the standard therapy and structured foot examination groups (enhanced therapy 8.5 vs. standard therapy 29.3%, P = 0.0046 and enhanced therapy vs. structured foot examination 30.4%, P = 0.0029). Patients in the standard therapy and structured foot examination groups were 4.37 and 4.71 times more likely to develop ulcers than patients in the enhanced therapy group. CONCLUSIONS - Infrared temperature home monitoring, in serving as an "early warning sign," appears to be a simple and useful adjunct in the prevention of diabetic foot ulcerations.

UR - http://www.scopus.com/inward/record.url?scp=33845991174&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845991174&partnerID=8YFLogxK

U2 - 10.2337/dc06-1600

DO - 10.2337/dc06-1600

M3 - Article

C2 - 17192326

AN - SCOPUS:33845991174

VL - 30

SP - 14

EP - 20

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 1

ER -