Remote Technology Identifies Diabetic Foot Ulcers

New monitoring technology based on a temperature sensitive mat can identify burgeoning hot spots, helping to prevent diabetic foot ulcers (DFUs).

The Podimetrics (Somerville, MA, USA) Remote Temperature Monitoring System consists of the wireless thermo-imaging SmartMat and a remote monitoring service. To use the system, the patient steps onto the SmartMat for 20 seconds, allowing it to identify temperature asymmetry at various locations between the two feet. A monitoring service alerts patients and physicians when such a “hot spot” is located, indicating that inflammation may develop. The patient and physician can then work together to prevent a DFU from forming.

In a study that involved 129 patients, at a temperature asymmetry threshold of 2.22 °C--the standard threshold used in previous plantar thermometry studies--the Podimetrics SmartMat correctly identified 97% of observed DFU, with an average lead time of 37 days. Increasing the temperature threshold to 3.20 °C decreased sensitivity to 70%, but reduced the false-positive rate from 57% to 32%. According to the researchers, 86% of the patients used the mat at least three times per week and 88% of respondents reported it being easy-to-use. The study was published in the July 2017 issue of Diabetes Care.

“In a real-world setting, when a doctor gets a notification that a patient has a hotspot, the patient will be advised to reduce physical activity for a period to let the developing wound heal or may be asked to come in for a visit in serious cases,” said lead author Professor Robert Frykberg, MD, of the University of Arizona (Phoenix, USA). “The Podimetrics Remote Temperature Monitoring System could have huge benefits for patients with diabetes who are at high risk by significantly reducing morbidity and mortality associated with diabetic foot ulcers, which could also lead to improvements in resource utilization.”

“These data reinforce our belief that the Podimetrics Remote Temperature Monitoring System may allow earlier detection of DFU and significant improvements in care,” said Jonathan Bloom, MD, CEO of Podimetrics. “This study demonstrates that patients find the Podimetrics SmartMat easy-to-use, which is critical for adherence, and ultimately achieving ongoing prevention of DFU and its devastating complications.”

Diabetes patients often suffer from nerve and circulation problems in the feet, which reduce their perception of pain. The nerve pathways that ensure that weight is automatically transferred from one foot to the other during prolonged standing are disrupted, and as a result, diabetics do not notice that their toes, heels, or the balls of their feet are too heavily loaded. The foot receives no relief, and pressure sores, DFUs, and infections may go unnoticed. Serious cases may even lead to amputation.

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