Smartphone Thermal Analysis for Diabetic foot Ulcer Prevention and treatment

Problem- Type II diabetes, or simply diabetes, is a major public health problem that is increasing dramatically [WHO-16]. In 2009, 347 million were suffering from this disease, and 500 million are expected in 2030 corresponding to a prevalence of 5.4%. Diabetes is the seventh cause of mortality in the world. Diabetes related diseases mainly affect the eyes, the heart, the kidney, the foot, the nervous system and blood vessels. The STANDUP project will focus on diabetic foot (DF). DF diseases include neuropathy, peripheral arterial diseases (ischemia), and infection. In the presence of a triggering factor, it may lead to ulceration and subsequent lower limb amputation. The annual incidence of foot ulceration among people with diabetes is approximately of 2%, and 15% of these will lead to a lower limb amputation. This implies that nowadays 600.000 diabetic foot ulcers occur each year in the EU-27 of which 90.000 will require an amputation. In the future, associated costs in terms of quality of life and health as well as sociable care expenditures are expected to strongly rise in DF if no measures are taken. Temperature is not currently well exploited even though it is an important factor in the evaluation of foot health and can strongly reduce the incidence of foot ulcer. Current thermal systems assessments are neither really effective nor friendly. Nevertheless the field shows potential for the development of system to detect abnormal thermal variations of the plantar foot. Background in DF thermography- In DF, the early diagnosis is one of the key issue. Once DF is detected, diabetes treatments are associated to DF education, regular foot care, and therapeutic insole. However, the incidence of serious complications, i.e. the occurrence of an ulcer and associates lower limb amputations, could further be reduced according to diabetes experts. Among all possible features than can help in such tasks, temperature is an important characteristic. At the European level, the project devoted to DF (FP7 projects PREVENTDFU, D-FOOTPRINT, EURODIALE, FOOT WOUND HEALING, SWAN-iCARE, VascColl) did not used the thermal information. The STANDUP project intends to go on step forward by offering simple and efficient tools for the evaluation of the thermal parameters in DF. There is a relationship between increased temperature and foot complications in diabetes: increased temperature may be present up to a week before a foot ulcer occurs [ARM-07]. Temperature of corresponding area of the right and left foot do not usually differs more than 1°C in diabetic foot. A temperature difference greater than 2.2°C is considered as abnormal and is called hyperthermia. Detecting hyperthermia in the plantar foot surface for high risk patients at home and providing adequate therapy reduces the incidence of foot ulcer by 3 [ARM-07]. This main result makes that this topic is of high interest, especially for the market since the commercial potential of such a system is tremendous. Various technologies have been developed to measure plantar foot temperature in various situations and to detect hyperthermia as described.