The thermoregulation of healthy individuals, overweight–obese, and diabetic from the plantar skin thermogram: a clue to predict the diabetic foot

ABSTRACT

Background: Thermoregulation is a complex autonomic process to keep or to dissipate heat in the human body.

Methods: In this work, by means of the thermogram of the plantar skin, the thermoregulation of healthy individuals, overweight–obese, and diabetic is discussed.

Results: The thermograms of the plantar skin, for the healthy individuals, are: (1) symmetrical, the temperature distribution of the right foot being a mirror image of that of the left foot ; (2) the thermograms of women, on average, are 3°C colder than those of the men; and (3) the temperature distributions decrease distally from the medial longitudinal arch. The plantar skin thermograms of overweight–obese individuals show: (1) increased average temperature of both feet and for both genders; (2) no symmetry between the left and right feet thermograms; and (3) the temperature distribution is still decreasing from the medial longitudinal arch to the periphery of the foot. However, the standard deviation, for each averaged temperature of the angiosomes, shows greater uncertainty. Most thermograms of diabetic individuals show temperature increase on the plantar skin, and are mostly symmetric between left and right feet.

Conclusions: An asymmetric thermogram of the plantar skin of diabetic individuals, where one foot is hotter than the other, may mean that the coldest foot is losing the capacity to communicate properly with the central nervous system and/or that vasoconstriction/vasodilatation is having problems in regulating the passing of blood through the vessels. Thus, the asymmetric thermograms of diabetic patients, and particularly those coldest regions of foot are of interest, because of the reduction of the local autonomic sensing and the lack of achieving properly the passing of the blood.

KEYWORDS:

• Thermoregulation
• thermogram
• overweight-obese
• diabetic
• angiosome
• diabetic foot

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

¹ An angiosome is a territory of a composite tissue for a given artery (or branches of different arteries), and it is represented on different parts of the skin [14,15].

² Instituto Nacional de Astrofísica, Óptica y Electrónica, is a national research facility that works together with health facilities in the country.

Additional information

Notes on contributors

Francisco-J Renero-C

Francisco-J. Renero-C received a Bachelor’s degree in physics from Universidad Autónoma de Puebla, Mexico, in 1987. He received the M.E. and Ph.D. from Osaka University in 1992 and 1995, respectively. In 2013, he received a bachelor degree in physiotherapy. He is currently titular researcher at the Optics Department, INAOE, in Mexico. His research interests are in optics for medical applications.