Diagnostic values for skin temperature assessment to detect diabetes-related foot complications

van Netten, Jaap J., Prijs, Miranda, van Baal, Jeff G., Liu, Chanjuan, van Der Heijden, Ferdi, & Bus, Sicco A. (2014) Diagnostic values for skin temperature assessment to detect diabetes-related foot complications. Diabetes Technology and Therapeutics, 16(11), pp. 714-721.

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Skin temperature assessment is a promising modality for early detection of diabetic foot problems, but its diagnostic value has not been studied. Our aims were to investigate the diagnostic value of different cutoff skin temperature values for detecting diabetes-related foot complications such as ulceration, infection, and Charcot foot and to determine urgency of treatment in case of diagnosed infection or a red-hot swollen foot.

Materials and Methods

The plantar foot surfaces of 54 patients with diabetes visiting the outpatient foot clinic were imaged with an infrared camera. Nine patients had complications requiring immediate treatment, 25 patients had complications requiring non-immediate treatment, and 20 patients had no complications requiring treatment. Average pixel temperature was calculated for six predefined spots and for the whole foot. We calculated the area under the receiver operating characteristic curve for different cutoff skin temperature values using clinical assessment as reference and defined the sensitivity and specificity for the most optimal cutoff temperature value. Mean temperature difference between feet was analyzed using the Kruskal–Wallis tests.


The most optimal cutoff skin temperature value for detection of diabetes-related foot complications was a 2.2°C difference between contralateral spots (sensitivity, 76%; specificity, 40%). The most optimal cutoff skin temperature value for determining urgency of treatment was a 1.35°C difference between the mean temperature of the left and right foot (sensitivity, 89%; specificity, 78%).


Detection of diabetes-related foot complications based on local skin temperature assessment is hindered by low diagnostic values. Mean temperature difference between two feet may be an adequate marker for determining urgency of treatment.

Impact and interest:

11 citations in Scopus
7 citations in Web of Science®
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ID Code: 93248
Item Type: Journal Article
Refereed: Yes
DOI: 10.1089/dia.2014.0052
ISSN: 1557-8593
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Divisions: Current > Schools > School of Clinical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2014 Mary Ann Liebert, Inc. Publishers
Deposited On: 29 Feb 2016 01:27
Last Modified: 24 Mar 2016 22:40

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