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

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

doi:10.1007/s00125-015-3616-6

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

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

9 Citations (Scopus)

Abstract

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 language	English
Journal	Diabetologia
Volume	58
Issue number	8
Pages (from-to)	1898-1906
ISSN	0012-186X
DOIs	https://doi.org/10.1007/s00125-015-3616-6
Publication status	Published - 2015

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Sejling, A.-S., Lange, K. H. W., Frandsen, C. S., Diemar, S. S., Tarnow, L., Faber, J., Holst, J. J., Hartmann, B., Hilsted, L., Kjaer, T. W., Juhl, C. B., Thorsteinsson, B., & Pedersen-Bjergaard, U. (2015). Infrared thermographic assessment of changes in skin temperature during hypoglycaemia in patients with type 1 diabetes. Diabetologia, 58(8), 1898-1906. https://doi.org/10.1007/s00125-015-3616-6

Sejling, A-S, Lange, KHW , Frandsen, CS , Diemar, SS, Tarnow, L, Faber, J, Holst, JJ, Hartmann, B, Hilsted, L, Kjaer, TW, Juhl, CB, Thorsteinsson, B & Pedersen-Bjergaard, U 2015, 'Infrared thermographic assessment of changes in skin temperature during hypoglycaemia in patients with type 1 diabetes', Diabetologia, vol. 58, no. 8, pp. 1898-1906. https://doi.org/10.1007/s00125-015-3616-6

@article{a8c1dd3eb73f41f4bdb1a018ee68444c,

title = "Infrared thermographic assessment of changes in skin temperature during hypoglycaemia in patients with type 1 diabetes",

abstract = "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.",

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

year = "2015",

doi = "10.1007/s00125-015-3616-6",

language = "English",

volume = "58",

pages = "1898--1906",

journal = "Diabetologia",

issn = "0012-186X",

publisher = "Springer",

number = "8",

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TY - JOUR

T1 - Infrared thermographic assessment of changes in skin temperature during hypoglycaemia in patients with type 1 diabetes

AU - Sejling, Anne-Sophie

AU - Lange, Kai H W

AU - Frandsen, Christian S

AU - Diemar, Sarah S

AU - Tarnow, Lise

AU - Faber, Jens

AU - Holst, Jens J

AU - Hartmann, Bolette

AU - Hilsted, Linda

AU - Kjaer, Troels W

AU - Juhl, Claus B

AU - Thorsteinsson, Birger

AU - Pedersen-Bjergaard, Ulrik

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

U2 - 10.1007/s00125-015-3616-6

DO - 10.1007/s00125-015-3616-6

M3 - Journal article

C2 - 25985748

SN - 0012-186X

VL - 58

SP - 1898

EP - 1906

JO - Diabetologia

JF - Diabetologia

IS - 8

ER -

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

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