The Use of AI-Powered Thermography to Detect Early Plantar Thermal Abnormalities in Patients With Diabetes: Cross-Sectional Observational Study.

Background: Diabetic foot problems are among the most debilitating complications of diabetes mellitus. Diabetes prevalence and complications, notably diabetic foot ulcers (DFUs), continue to rise, challenging health care despite advancements in medicine. Traditional DFU detection methods face scalability issues due to inefficiencies in time and practical application, leading to high recurrence and amputation rates alongside substantial health care costs. Human medical thermography could significantly enhance disease monitoring and detection, including DFUs. Objective: This study evaluated the efficacy of artificial intelligence-powered thermography in detecting plantar thermal patterns that differentiate between adult patients with diabetes with no visible foot ulcers and healthy individuals without diabetes. Methods: This cross-sectional observational study included 200 patients-100 healthy and 100 with diabetes without a visible foot ulcer. Initial data were gathered through a questionnaire. Participants were prepared for thermal imaging to capture plantar thermal patterns. All collected data, including thermal images and questionnaire responses, were stored on a password-protected computer to ensure confidentiality and data integrity. Results: In this study, participants were categorized into 2 groups: a healthy control group (n=98) with no prior diabetes or peripheral artery disease diagnosis and normal circulatory findings, and a group with diabetes (n=98) comprising patients with diabetes, regardless of peripheral circulatory status. Temperature analysis indicated a wider range in the group with diabetes (18.1-35.6 °C) than in the healthy controls (21.1-35.7 °C), with the former showing significantly higher mean temperatures (mean 29.0 °C, SD 3.0 °C) than controls (mean 28.9 °C, SD 2.8 °C; P<.001). Analysis of both feet revealed significantly greater differences between feet in the group with diabetes and the controls (control: mean 0.47 °C, SD 0.43 °C; group with diabetes: mean 1.78 °C, SD 1.58 °C; P<.001; 95% CI 0.99-1.63). These results identified clinically relevant abnormalities in 10% of the cohort with diabetes, whereas no such findings were observed in the control group. We used a linear regression model to indicate that being diagnosed with diabetes is a significant predictor of abnormal temperature, while age and sex were not found to be significant predictors in this model. Conclusions: DFUs pose a significant health risk for patients with diabetes, making early detection crucial. This study highlights the potential of an artificial intelligence-powered computer vision system in identifying early signs of diabetic foot complications by differentiating thermal patterns between patients with diabetes with no visible ulcers and healthy individuals. The findings suggest that the technology could improve early diagnosis and outcomes in diabetic foot care, although further research is needed to fully validate its effectiveness. The ability of the technology to detect compromised blood supply indicates its value in preventative clinical strategies.