A walking bout reveals altered foot thermodynamics associated with unilateral transtibial amputation among individuals with type 2 diabetes.

Abstract

Increased foot temperature among individuals with type 2 diabetes can be predictive of diabetic foot ulcer development. A combination of physiological and mechanical deficiencies may contribute to elevations in intact foot temperature during gait for individuals with type 2 diabetes and transtibial amputation. This study evaluated plantar foot temperature differences between individuals with type 2 diabetes with and without transtibial amputation. We hypothesized that individuals with transtibial amputation maintain increased foot temperature compared to those without amputation. Cross-sectional, case control. A sample of 16 participants with type 2 diabetes and transtibial amputation, and 16 age- and sex-matched participants with type 2 diabetes without amputation were recruited. Foot temperatures were measured during resting, walking, and cooldown periods. Peak temperature, mean temperature, and rate of temperature change were analyzed for each period, and compared between cohorts. Participants with amputation exhibited increased mean foot temperature while at rest and during walking. Participants without amputation exhibited increased rate of change of foot temperature during walking. No differences in peak temperature or rate of temperature change were observed during the baseline or cooldown periods. The current findings of altered foot temperature for individuals with transtibial amputation and type 2 diabetes suggest a possible reason for the high rates of contralateral limb ulceration and amputation among this population.