Sage Journals: Discover world-class research

Abstract

Background and Objective:

Diabetic problems are more common in the lower extremity and linked with high mortality rate which affects public health system. The present study focused on monitoring the changes in tissue oxygenation concentrations using Near infrared spectroscopy system along with temperature and hardness of the foot tissues.

Methods:

Control subjects (without diabetes) and diabetic patients without neuropathy were selected for this study and three standard foot risk areas were considered. Standard induced ischemic stimulus was given to assess the response of the designed system and to analyze the changes in oxyhemoglobin and deoxyhemoglobin levels during venous occlusion.

Results:

Results showed significant differences in the tissue oxygenation index value in all three standard areas where oxygenation value at the foot areas were significantly low ( $p < 0.05$ ) in diabetic group as compared to control group. Also, significant difference were found in tissue hardness value when comparing between groups, where the diabetic group had significantly high ( $p < 0.05$ ) tissue hardness at area 5 and area 8 as compared to control groups.

Conclusion:

Therefore, the present study concludes that high tissue hardness had significant effect on tissue oxygenation index that affects vascular circulation and this condition could be assessable using NIRS technique in order to find risky areas at the foot sole.

Keywords

Diabetes near-infrared spectroscopy plantar foot complications foot ulcers tissue oxygenation index

Get full access to this article

View all access options for this article.

References

Agale

S.V.

, Chronic leg ulcers: Epidemiology, aetiopathogenesis, and management, Ulcers. 2013 (2013), 1–9. doi:10.1155/2013/413604.

Alexiadou

and Doupis

, Management of diabetic foot ulcers, Diabetes Ther. 3 (2012), 1–15. doi:10.1007/s13300-012-0004-9.

Aziz

and Cullum

, Electromagnetic therapy for treating venous leg ulcers, Cochrane Database Syst. Rev. 2015 (2015). doi:10.1002/14651858.CD002933.pub6.

Bansal

Kalita

and Misra

U.K.

, Diabetic neuropathy, Postgrad. Med. J. 82 (2006), 95–100. doi:10.1136/pgmj.2005.036137.

Bowling

F.L.

Rashid

S.T.

and Boulton

A.J.M.

, Preventing and treating foot complications associated with diabetes mellitus, Nat. Rev. Endocrinol. 11 (2015), 606–616. doi:10.1038/nrendo.2015.130.

Cade

W.T.

, Diabetes-related microvascular and macrovascular diseases in the physical therapy setting, Phys. Ther. 88 (2008), 1322–1335. doi:10.2522/ptj.20080008.

Forbes

J.M.

and Cooper

M.E.

, Mechanisms of diabetic complications, Physiol. Rev. 93 (2013), 137–188. doi:10.1152/physrev.00045.2011.

Gerlach

Krumm

Illing

Lange

Kanoun

Odenwald

and Hubler

, Printed MWCNT-PDMS-composite pressure sensor system for plantar pressure monitoring in ulcer prevention, IEEE Sens. J. 15 (2015), 3647–3656. doi:10.1109/JSEN.2015.2392084.

Grennan

, Diabetic foot ulcers, JAMA – J. Am. Med. Assoc. 321 (2019), 114. doi:10.1001/jama.2018.18323.

10.

Hamaoka

McCully

K.K.

Quaresima

Yamamoto

and Chance

, Near-infrared spectroscopy/imaging for monitoring muscle oxygenation and oxidative metabolism in healthy and diseased humans, J. Biomed. Opt. 12 (2007), 062105. doi:10.1117/1.2805437.

11.

Keller

P.B.

Wille

Van Ramshorst

and Van der Werken

, Pressure ulcers in intensive care patients: A review of risks and prevention, Intensive Care Med. 28 (2002), 1379–1388. doi:10.1007/s00134-002-1487-z.

12.

Lin

O.H.

Lai

J.Y.

Tsai

H.Y.

Lin

Lai

and Tsai

, Preventing diabetes extremity vascular disease with blood oxygen saturation images, Int. J. Instrum. Sci. 2 (2013), 1–7.

13.

Manfredini

Lamberti

Rossi

Mascoli

Basaglia

and Zamboni

, A toe flexion NIRS assisted test for rapid assessment of foot perfusion in peripheral arterial disease: Feasibility, validity, and diagnostic accuracy, Eur. J. Vasc. Endovasc. Surg. 54 (2017), 187–194. doi:10.1016/j.ejvs.2017.04.013.

14.

Myers

D.E.

Anderson

L.D.

Seifert

R.P.

Ortner

J.P.

Cooper

C.E.

Beilman

G.J.

and Mowlem

J.D.

, Noninvasive method for measuring local hemoglobin oxygen saturation in tissue using wide gap second derivative near-infrared spectroscopy, J. Biomed. Opt. 10 (2005), 034017. doi:10.1117/1.1925250.

15.

Nagdyman

Fleck

Barth

Abdul-Khaliq

Stiller

Ewert

Huebler

Kuppe

and Lange

P.E.

, Relation of cerebral tissue oxygenation index to central venous oxygen saturation in children, Intensive Care Med. 30 (2004), 468–471. doi:10.1007/s00134-003-2101-8.

16.

Neidrauer

Zubkov

Weingarten

M.S.

Pourrezaei

and Papazoglou

E.S.

, Near infrared wound monitor helps clinical assessment of diabetic foot ulcers, J. Diabetes Sci. Technol. 4 (2010), 792–798. doi:10.1177/193229681000400404.

17.

Pichler

Urlesberger

Jirak

Zotter

Reiterer

Müller

and Borkenstein

, Reduced forearm blood flow in children and adolescents with type 1 diabetes (measured by near-infrared spectroscopy), Diabetes Care. 27 (2004), 1942–1946. doi:10.2337/diacare.27.8.1942.

18.

Reiber

G.E.

Smith

D.G.

Vileikyte

Lavery

L.A.

Boyko

E.J.

Boulton

A.J.M.

and Del Aguila

, Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings, Diabetes Care. 22 (1999), 157–162. doi:10.2337/diacare.22.1.157.

19.

Scheeren

T.W.L.

Schober

and Schwarte

L.A.

, Monitoring tissue oxygenation by near infrared spectroscopy (NIRS): Background and current applications, J. Clin. Monit. Comput. 26 (2012), 279–287. doi:10.1007/s10877-012-9348-y.

20.

Seshadri

N.P.G.

and Periyasamy

, Design of multi-wavelength near infrared probe to detect risk areas in diabetic foot, in: Biotechnol. Appl. Hum. Heal., Springer, 2020, pp. 1–9.

21.

Shivwanshi

R.R.

Seshadri

N.P.G.

and Periyasamy

, A review of present and futuristic development of near infrared spectroscopy system in the assessment of diabetic foot risk, in: 2018 Fourth Int. Conf. Biosignals, Images Instrum., IEEE, 2018, pp. 206–212.

22.

Tabish

S.A.

, Is diabetes becoming the biggest epidemic of the twenty-first century?, Int. J. Health Sci. (Qassim) 1 (2007), V–VIII, http://www.ncbi.nlm.nih.gov/pubmed/21475425%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3068646 .

23.

Ubbink

D.T.

and Koopman

, Near-infrared spectroscopy in the routine diagnostic work-up of patients with leg ischaemia, Eur. J. Vasc. Endovasc. Surg. 31 (2006), 394–400. doi:10.1016/j.ejvs.2005.10.025.

24.

Van Acker

Bouhassira

De Bacquer

Weiss

Matthys

Raemen

Mathieu

and Colin

I.M.

, Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics, Diabetes Metab. 35 (2009), 206–213. doi:10.1016/j.diabet.2008.11.004.

25.

Volmer-Thole

and Lobmann

, Neuropathy and diabetic foot syndrome, Int. J. Mol. Sci. 17 (2016). doi:10.3390/ijms17060917.

Non-invasive assessment of tissue oxygenation parameters in diabetic patients foot sole using near infrared spectroscopy