Infrared thermographic assessment of changes in skin temperature during hypoglycaemia in patients with type 1 diabetes

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Anne-Sophie Sejling, Kai H W Lange, Christian S Frandsen, Sarah S Diemar, Lise Tarnow, Jens Faber, Jens J Holst, Bolette Hartmann, Linda Hilsted, Troels W Kjaer, Claus B Juhl, Birger Thorsteinsson, Ulrik Pedersen-Bjergaard

AIMS/HYPOTHESIS: Hypoglycaemia is associated with reduced skin temperature (Ts). We studied whether infrared thermography can detect Ts changes during hypoglycaemia in patients with type 1 diabetes and how the Ts response differs between patients with normal hypoglycaemia awareness and hypoglycaemia unawareness.

METHODS: Twenty-four patients with type 1 diabetes (ten aware, 14 unaware) were studied during normoglycaemia (5.0-6.0 mmol/l), hypoglycaemia (2.0-2.5 mmol/l) and during recovery from hypoglycaemia (5.0-6.0 mmol/l) using hyperinsulinaemic glucose clamping. During each 1 h phase, Ts was measured twice by infrared thermography imaging in pre-defined areas (nose, glabella and the five left fingertips), symptoms of hypoglycaemia were scored and blood was sampled.

RESULTS: Ts decreased during hypoglycaemia on the nose and glabella. The highest decrements were recorded on the nose (aware: -2.6°C, unaware: -1.1°C). In aware patients, the differences in temperature were statistically significant on both nose and glabella, whereas there was only a trend in the unaware group. There was a significant difference in hypoglycaemia-induced temperature changes between the groups. Patients in the aware group had higher hypoglycaemia symptom scores and higher adrenaline (epinephrine) levels during hypoglycaemia.

CONCLUSIONS/INTERPRETATION: The hypoglycaemia-associated decrement in Ts can be assessed by infrared thermography and is larger in patients with normal hypoglycaemia awareness compared with unaware patients.

Original languageEnglish
JournalDiabetologia
Volume58
Pages (from-to)1898–1906
Number of pages9
ISSN0012-186X
DOIs
Publication statusPublished - 2015

ID: 149078651