Ethnicity and outcomes in a 20-week, randomized, controlled trial (TITRATE study)

Abstract

authors’ research has shown that skin temperature monitoring at home reduces re-ulceration rates by 4to 10-fold. Currently, the authors are investigating thermometry in dynamic state to model thermal changes during activity of daily living, develop prediction model for wound healing and combining thermography with other imaging modalities to futher understanding about diabetic foot infections. In three independent clinical trials our group investigated the efficacy of the thermometry for lower extremities, with the intent to reduce recurrence of ulceration. Educating patients about self-monitoring and providing a hand-held digital thermometer achieved significant reductions in re-ulceration. In a recent study by our group involving a clinical thermometry test, it is shown for the first time, the evidence of poor recovery times for the diabetic foot with neuropathy when assessing the foot under load. Diabetics with neuropathy show the highest ‘delta temperature’ i.e. difference between the temperature after 10 minute recovery period and baseline temperatures measured independently. A temperature deficit (due to poor recovery to baseline temperature) suggests degeneration of thermoreceptors leading to diminished hypothalamus mediated activity in the diabetic neuropathic group. There is a growing body of evidence emerging from our group’s work in this area to build a knowledge base in thermal measurements. The long term goal of this research is to further the role of thermometry and thermography in clinical care for the diabetic foot. There are incremental benefits from a well equipped foot care team that includes patient education or counselling for self monitoring of their condition, which have been shown to be successful.