Abstract
Diabetes Mellitus (DM) is one of the severe public health-care chronic disease issue, with about 422 millions of patients worldwide in 2017. DM is a serious pathology, especially through the severity of its microvascular complications (diabetic retinopathy, diabetic nephropathy, neuropathy) and macro vascular complications (ischemic heart disease, peripheral arterial disease). Among these complications, “diabetic foot”, is a complex disease with a medical, social (lifestyle), human (quality of life) and economic (high cost for the health care systems) major impact.Through this doctoral thesis, one of the interest is to connect this pathology, including complications, to the skin temperature. By evaluating the mechanisms responsible for the two most common complication, peripheral neuropathy (nerve damage) and peripheral artery disease (vascular structures damage), and the effects of these two complications on the body, one can show that it is possible to connect skin temperature oscillations to the state of the pathology, thanks to the evaluation of the thermoregulatory activity.This work is based on: (i) numerical models to connect skin blood flow oscillations to skin thermal oscillations; (ii) an important phase of accurate metrology to use an infrared micro-bolometer camera; (iii) development of an experimental protocol enable to activate and enhance thermoregulatory mechanisms; and (iv) the quantification of the intensity of these mechanisms in function of different groups of subjects, with or without DM.