Loss of temperature and pain sensation is responsible for most neuropathic diabetic foot lesions. The determination of vibration sensation is often used as screening method for patients not directly obvious, whereas, temperature sensation is related with the contents of diabetes education programmes. Therefore, we tested the validity of TIP THERM®: as a screening method for the loss of temperature sensation in 50 patients with diabetes (age 48 ± 15, diabetes duration 16 ± 11; mean±SD). TIP THERM®: looks like a thick pencil and is made out of 2 materials with different conductivity for heat (steel and plastic) and has a definded geometry. When touching the skin a subjective temperature difference is felt. For comparison, temperature sensation was measured with a THERMOCROSS® and vibration sensation with a graduated tuning fork. All temperature sensation were determined on the dorsum of the foot. In an earlier study, normal temperature sensation measured with a THERMOCROSS® was <10°C temperature difference. All 26 patients with normal temperature sensation (<10°C) recognised the different subjective temperature sensation with TIP THERM®: and 20 of the 24 patients with disturbed temperature sensation (≥10°C were unable to recognise the difference.
In conclusion, TIP THERM® (tip therm GmbH, Düsseldorf, FRG) is a simple, reliable and inexpensive screening method to determine a disturbed temperature sensation in diabetic neuropathy.