Hot spots warn of diabetic foot ulcers
Updated: 2008-01-15 08:41
Treating a simple diabetic foot ulcer can cost $8,000, double that for an infected one and even more for an amputation.
"It's basically idiot-proof," Walter Massa of Skokie, Ill., says of the thermometer.
"On the other hand, it's very hard to take your temperature when you don't think there's a problem there," cautions Massa, 53, who has used the thermometer since Armstrong helped him narrowly avoid amputation when the joints in his foot disintegrated. "There's something you have to teach yourself."
Some 21 million Americans have diabetes, meaning their bodies can't properly regulate blood sugar, or glucose. Over many years, high glucose levels seriously damage blood vessels and nerves that lead to, among other things, loss of sensation in the feet and poor blood flow in the lower legs — the ulcer environment.
There is little therapy to avert foot ulcers. Patients are urged to wear proper-fitting shoes and check their feet daily for redness, bumps or other signs of trouble.
But day-to-day changes are hard to spot. In an NIH-funded study last year, Texas A&M College of Medicine researchers reported 30 percent of patients got ulcers even when using a mirror to check their soles, compared with 8.5 percent of thermometer users.
The new study, funded by the Department of Veterans Affairs and published in last month's American Journal of Medicine, is the biggest yet, tracking 225 patients for 18 months. Some 12.2 percent who did standard feet checks got ulcers, compared with 4.7 percent of thermometer users.
Participant Paul Rau of Green Valley, Ariz., had a recurring ulcer on his left big toe for six years, a quarter-inch bone-deep hole that took weeks to heal each time. While using the thermometer, Rau says his ulcer came back far less frequently, and when it did it was a quick-healing shallow crack.
"How it helped me was I checked my feet better," says Rau, 60. "There were so many points on your feet you had to do."
While the results are compelling, the studies are small and NIH's Jones says the thermometer should be included in larger studies to prove long-term benefit.
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