title: Rewarming index of the lower leg assessed by infrared thermography in adolescents with type 1 diabetes mellitus.
abstract: The aim of this study was to determine whether infrared thermography before and after challenge of the lower leg in cold water may be a useful tool to detect abnormalities in skin blood flow in adolescent asymptomatic patients with type 1 diabetes mellitus (DM1) and to assess the optimal setting of skin temperature measurements. Twenty-five adolescents (10 female, 15 male, mean age 21.2 +/- 6.2 years, body mass index [BMI] 23.0 +/- 2.1 kg/m2) with a duration of DMI of 13.8 +/- 5.4 years and mean HbA1c levels 8.5 +/- 1.3% were compared to age- and sex-matched controls (BMI 22.9 +/- 2.2 kg/m2). Seven defined sites of the lower leg were assessed by infrared thermography before and for 10 min after exposure of the leg to 14 degrees C cold water. As skin temperature before exposure to cold water differs from individual to individual and basal temperature was significantly warmer in patients at the tip of the first (p < 0.05) and fifth (p < 0.05) toe, the rewarming index was calculated in order to compare data. Rewarming indexes of skin temperature during the whole measurement procedure (0-10 min) were significantly lower at the tip of the first (p < 0.05) and fifth (p < 0.01) toes and from minute 2-10 also at the inner ankle (p < 0.05) in patients compared to healthy controls. Rewarming indexes of the other four sites were not significantly different between patients and controls. Infrared thermography of the lower leg after cold water exposure is an easily applicable method and a useful tool to detect abnormalities of skin blood flow in adolescents with DM1 especially at the tips of the first and fifth toes and the inner ankle.
authors.affiliation: Department of Pediatrics, University of Graz, Graz, Austria. heinz.zotter@klinikum-graz.at
authors.forename: Heinz
authors.initials: H
authors.lastname: Zotter
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kerbl
authors.forename: Siegfried
authors.initials: S
authors.lastname: Gallistl
authors.forename: Hilde
authors.initials: H
authors.lastname: Nitsche
authors.forename: Martin
authors.initials: M
authors.lastname: Borkenstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000842:Ankle / Q000098:blood supply / Q000503:physiopathology / Q000528:radiation effects; D015992:Body Mass Index; D001833:Body Temperature Regulation / Q000528:radiation effects; D003080:Cold Temperature / Q000009:adverse effects; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000737:chemistry / Q000378:metabolism; D006801:Humans; D007035:Hypothermia / Q000175:diagnosis / Q000503:physiopathology; D007101:Immersion; D007259:Infrared Rays; D007866:Leg; D008297:Male; D008682:Metatarsal Bones / Q000098:blood supply / Q000503:physiopathology / Q000528:radiation effects; D012039:Regional Blood Flow / Q000528:radiation effects; D017694:Rewarming; D012867:Skin / Q000098:blood supply / Q000503:physiopathology / Q000528:radiation effects; D012881:Skin Temperature / Q000502:physiology / Q000528:radiation effects; D013817:Thermography / Q000379:methods*; D013997:Time Factors; D014034:Toes / Q000098:blood supply / Q000503:physiopathology / Q000528:radiation effects; D014867:Water
chemical_list: D006442:Glycated Hemoglobin; D014867:Water