JBI Evid Synth. 2026 Sep 1;24(9):1755-1781. doi: 10.11124/JBIES-25-00538. Epub 2026 Jul 28.
ABSTRACT
OBJECTIVE: The objective of this review was to examine the potential benefits of plantar foot temperature monitoring in adults (18 years or older) with type 1 or type 2 diabetes mellitus without active ulcers at baseline.
INTRODUCTION: Diabetic foot ulcers represent a major complication of diabetes mellitus, leading to significant morbidity, risk of amputation, and health care costs. Early detection of inflammatory changes through temperature monitoring may provide an effective strategy for prevention.
ELIGIBILITY CRITERIA: This umbrella review included systematic reviews of randomized controlled trials involving adults with type 1 or type 2 diabetes and no active foot ulcers, assessing plantar temperature monitoring (thermometry and/or thermography). Any comparator was eligible, and the primary outcome was plantar ulcer incidence. Reviews of observational or non-systematic studies and those involving children or gestational diabetes were excluded.
METHODS: This umbrella review followed JBI methodology. The searches were conducted on January 30, 2024, in the following databases: CINAHL (EBSCOhost), Cochrane Library, Embase.com, Epistemonikos, JBI Evidence Synthesis, PubMed, Scopus, Web of Science, and LILACS. The methodological quality of included studies was assessed using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses and the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2) tool.
RESULTS: Seven systematic reviews published between 2013 and 2023 were included, all with meta-analyses and high methodological quality. The reviews comprised between 4 and 22 randomized controlled trials evaluating infrared dermal thermometry, consistently involving individuals at high risk of foot ulceration. Across reviews, home-based foot temperature monitoring significantly reduced ulcer incidence compared with standard care, with pooled effect estimates ranging from risk ratio (RR) 0.37 (95% CI 0.21-0.66) to RR 0.53 (95% CI 0.29-0.96), and odds ratio (OR) 0.51 (95% CI 0.31-0.84), indicating an approximate halving of ulcer risk. However, a very high degree of overlap was identified, with more than 90% of primary studies included in multiple reviews. No eligible systematic reviews specifically evaluating thermography were identified, and evidence remains limited for individuals not at increased risk of foot ulceration.
CONCLUSIONS: The aggregated results support home-based foot temperature monitoring as a promising strategy to reduce the risk of foot ulceration among people with diabetes at high risk of ulceration. Its effectiveness in people with diabetes who are not at increased risk of developing foot ulcers remains uncertain.
REVIEW REGISTRATION: PROSPERO CRD42024509838.
SUPPLEMENTAL DIGITAL CONTENT: A Spanish-language version of the abstract is available at https://links.lww.com/SRX/A194.
PMID:42714193 | DOI:10.11124/JBIES-25-00538