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PODIUM™ - A home device and cloud-based software and algorithm for diabetic foot ulcer monitoring

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A home device for monitoring diabetic foot ulcers

There are 60 million adults suffering from diabetes in Europe. Diabetes-associated morbidities such as diabetic foot ulcers (DFUs) could lead to amputations if left untreated, calling for novel tools for prompt diagnosis.

Society
Health

Diabetic patients often suffer from neuropathy, which causes them to lose sensation in their feet. Alongside the poor blood supply and the compromised immune system, this can lead to the development of DFU. Accumulating evidence indicates a 12-25 % lifetime risk of developing DFU, which however can be prevented by the prompt screening of inflammatory reactions in the foot.

A device that measures foot temperature as a sign of inflammation

In this context, the EU-funded PODIUM project developed a device that can detect the excess heat that the human body generates during an inflammatory response. This response often starts before the tissue damage is irreversible. “Our goal was to detect foot inflammation well in advance, before the development of ulcers,″ explains project coordinator Dr Peter Plassmann. Previous clinical work by the Thermetrix Ltd company had demonstrated the feasibility of employing a thermal (infrared) camera to obtain temperature patterns and associate them with underlying problems. Alongside the work by other groups, this information led to the design of the PODIUM device. The device uses a thermochromic liquid crystal sheet similar to the ones used in forehead thermometer strips that changes colour with temperature. People place their feet on the device and the sheet shows the temperature map of the feet in a range of colours. A camera in the device records these colour maps while the built-in software analyses them for signs of problems, such as asymmetry between left and right foot, spots of very high temperatures or sudden changes from a previous image. During the project, partners tested the technical performance of the PODIUM device in terms of accuracy and precision. Overall, it demonstrated superior features compared to moderately expensive infrared cameras that only have an accuracy of +/- 2 degrees Celsius. Partners are currently in the process of submitting an EIC Accelerator grant application to further improve this performance.

Future prospects

According to Plassmann “the project progressed faster than expected and we could utilise its outcome to quickly produce an already marketable device.″ The PODIUM first device is registered as a Class I medical device and through rapid temperature imaging offers a 10 times higher sensitivity and reliability than any competitive solution. Importantly, it offers diabetic patients the opportunity of performing daily measurements in the comfort of their own home. The telemedicine feature incorporated in the device ensures the physician receives the information and makes evidence-based decisions. For healthcare practitioners such as podiatrists, the PODIUM device comprises an important tool for monitoring the health of their patients, thereby improving healthcare quality and quality of life. Considering that over nine million Europeans are at risk of suffering from DFU in their lifetime and that the vast majority of amputees will die within five years, the PODIUM device is expected to have a huge socioeconomic impact. Thermetrix Ltd plan to release the device first in private podiatry clinics. Provided additional funding is available, they will proceed with other institutional health care providers. “Implementation of the device in just 5 % of diabetes sufferers who are at risk of developing DFU, will lead to significant reduction of lower limb amputations and associated healthcare costs,″ concludes Plassmann.

Keywords

PODIUM, device, diabetic foot ulcers (DFU), temperature, diabetes, inflammation, amputation, podiatry, telemedicine

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