Effect of thermometry on the prevention of diabetic foot ulcers: a systematic review with meta-analysis.
Açucena Leal de Araújo, Francisca Diana da Silva Negreiros, Raquel Sampaio Florêncio and 3 others
PMID 35584410WHAT IT FOUND
People with diabetes who used a home infrared foot thermometer and diary recording, sometimes with counseling and a pedometer, had fewer new foot ulcers than standard foot care, with moderate certainty evidence.
Key findings
01Four RCTs with 547 participants were pooled; the foot temperature monitoring intervention was associated with a lower risk of new diabetic foot ulcers than standard foot care (RR 0.53, 95% CI 0.29 to 0.96, p=0.03).
02The intervention was not a thermometer alone: patients used a handheld infrared thermometer and recorded foot temperatures, and one trial also included theory-based counseling and a pedometer.
03The evidence was rated moderate certainty, with serious imprecision because the number of ulcer events was low.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only five trials were found, and only four with 547 participants could be pooled; one trial did not report allocation numbers. The trials were mostly in older men with type 2 diabetes and high ulcer risk, so the result may not apply to women, younger adults, or lower-risk patients. Heterogeneity was substantial (I²=55%), and the GRADE assessment rated imprecision as serious because the number of ulcer events was low. Two trials found no difference between groups, so the pooled positive result is not consistent across all studies. The intervention included diary recording and sometimes counseling and a pedometer, so the effect of thermometry alone cannot be separated. Adherence to daily home temperature monitoring may be lower in real-world practice than in the trials. The review did not evaluate cost or feasibility in wider populations. Some studies had uncertain or high risk of bias for random sequence generation, allocation, or selective reporting.
The easy way to misread this
Do not conclude that a thermometer alone prevents diabetic foot ulcers. The intervention also included diary recording, and one trial added counseling and a pedometer. Two trials found no difference, and the evidence was moderate.