Thermographic measurement of skin temperature recovery time of extremitiesin patients with type 2 diabetes mellitus

To elucidate the relationship between the recovery of skin temperature in a n extremity after exposure to cold water and various factors associated wit h diabetes, we measured skin temperature in type 2 diabetic patients (N=61) and control subjects (N=16). A thermo-tracer was used in thermographic mea surements. The right third toe of each subject was immersed in cold water a t 0 degrees C for 10 sec. R-t represents the recovery rate of skin temperat ure at t min after exposure. R-t was significantly reduced in the diabetic patients every 5 min in the 20 min period following exposure compared with control subjects. The diabetic patients group exhibited a significantly pos itive correlation between R-20 and the ankle-brachial index. R-20 in the di abetic patients showed a significantly positive correlation with the reduct ion in systolic blood pressure at the arm observed in Schellong's test, in addition, R-20 showed a significantly negative correlation with plasma leve ls of fibrinogen and plasminogen activator inhibitor-1. However, the severi ty of diabetic retinopathy and nephropathy was not significantly related to R-20 in the diabetic patients. The present data indicate that the recovery of skin temperature after immersion in cold water was markedly reduced in patients with type 2 diabetes mellitus as compared with healthy control sub jects. Peripheral arteriosclerosis, impaired sympathetic nerve function and the activation of the blood coagulation system may all contribute to this reduced recovery of skin temperature.