Análise da pressão plantar máxima e da temperatura cutânea dos pés de pessoas com diabetes mellitus tipo 2 com risco para o pé diabético

Abstract

Studies show that people diagnosed with Type 2 Diabetes Mellitus (DM2), who have high plantar pressure points and foot temperature changes, are more prone to the appearance of ulcers and plantar lesions, infections and amputations in the lower limbs. It is important to understand the behavior of these variables so that preventive measures can be implemented in the routine of these subjects. Few studies have evaluated the behavior of the Plantar Cutaneous Temperature (TCP) (ºC) and its relationship with the Maximum Plantar Pressure (PPM) (kPa) in diabetics. However, the aim of this study was to analyze the PPM and TCP of the feet of people with DM2 at risk for Diabetic Foot. This is a retrospective longitudinal study, based on a database of 208 volunteers, whose clinical characteristics were considered. A total of 416 feet were analyzed, which had TCP and PPM evaluated by infrared thermographic camera and baropodometry, respectively. The TCP points corresponding to the PPM points were evaluated from a transparency model, containing the baropodometric image, which was positioned over the thermographic image, on the computer screen. Data normality was verified by the Shapiro Wilk test; We continued with the Wilcoxon, Mann-Whitney and Kruskal-Wallis tests for comparisons between the PPM and TCP points between the feet, and for comparisons between PPM and TCP with the sample variables. Spearman's test correlated continuous variables. The results show differences in PPM between the feet, with lower pressures being observed at the point equivalent to the foot with greater pressure, that is, on the contralateral foot (p<0.001); significant differences in maximum pressure were observed in the body mass index (BMI), characterized as obesity II, and in the anatomical location of the hindfoot, both in the foot with higher pressure (p=0.006; p<0.001) and in the contralateral foot (p =0.023; p=0.004). Significantly lower values ​​of TCP are seen in people with high risk of diabetic foot and capillary blood glucose lower than 100 mg/dl (p=0.008; p=0.004), as well as in the contralateral foot (p=0.014; p=0.005). The PPM points are positively correlated between the feet and also with temperature, with a weak correlation. There was also a strong correlation of TCP between the feet. The PPM point is positively correlated with body mass and BMI. It can be concluded that PPM and TCP are correlated and may be linked to the variables body mass, BMI, risk of diabetic foot and capillary blood glucose.