IntroductionDiabetic peripheral neuropathy (DPN) causes morbidity and affects the quality of life. Before diabetes diagnosis, neuropathic damage may be present. Sudoscan provides accurate measurement of the sudomotor function. This study aimed to assess the abnormalities detected by Sudoscan, offered estimates of DPN prevalence, and investigated the relationship between metabolic and clinical parameters. Additionally, we evaluated the diagnostic accuracy of the Sudoscan compared with monofilament and tuning fork tests for detecting DPN.Research design and methodsCross-sectional descriptive study including patients with type 2 diabetes for <5 years since diagnosis. We investigated the presence of DPN using a 128 Hz tuning fork test, the 10 g monofilament, and the sudomotor dysfunction in feet using Sudoscan. We compared patients with and without alterations in the Sudoscan. A logistic regression model analyzed variables independently associated with sudomotor dysfunction.ResultsFrom 2013 to 2020, 2243 patients were included, 55.1% women, age 51.8 years, and 17.1% with normal weight. Monofilament tests and/or tuning fork examination were abnormal in 29% (95% CI 0.23% to 0.27%) and 619 patients (27.6%, 0.25% to 0.29%) had sudomotor alterations. In logistic regression analysis, age (β=1.01, 0.005–1.02), diastolic blood pressure (β=0.98, 0.96–0.99), heart rate (β=1.01, 1.00–1.02), glucose (β=1.00, 1.00–1.03), albuminuria (β=1.001, 1.000–1.001), beta-blockers=1.98, 1.21–3.24) and fibrate use=0.61, 0.43–0.87) were associated with sudomotor dysfunction. The AUC (area under the curve) for Sudoscan was 0.495 (0.469–0.522), with sensitivity and specificity of 24% and 71%, respectively.ConclusionThe Sudoscan identified an important proportion of patients with dysfunction, allowing prompt intervention to decrease the risk for complications.Trial registration numberNCT02836808.

In 2020, several countries established a global emergency state. Lockdowns restricted people's lifestyles and daily activities to prevent coronavirus spread. These measures hindered diabetes mellitus control and lifestyle changes. This study aims to evaluate if attending a multidisciplinary program before the pandemic helped maintain a good metabolic state, lifestyle modifications, and mental health in patients with diabetes mellitus during the COVID-19 lockdown. Methods: Patients included in this study attended a multidisciplinary program, with <5 years of diagnosis of type 2 diabetes, without disabling complications, between 18-70 years old. The complete lockdown occurred from February 27, 2020, to May 31, 2020. The first patient (non-COVID) to return to the center for face-to-face consultation was in March 2021. Consultations in 2019 were face-to-face and changed to a virtual modality during 2020. We analyzed metabolic, lifestyle, mental health, and diabetes education parameters. Results: A total of 133 patients with type 2 diabetes mellitus were included with complete information in visits before and during the lockdown. Metabolic parameters and self-care measures (nutrition plan, foot evaluation, and self-glucose monitoring) evaluated on our patients had no change during the lockdown. We found a significant increase in the time patients spent sitting during the day (p<0.05). Barriers to exercise increased during lockdown, being joint pain (3.8% to 12.0%, p<0.01) and lack of time to exercise (4.5% to 7.5%, p=0.33) being the most common. There was no significant difference in symptoms of anxiety and depression, quality of life, and empowerment. Conclusion:A multidisciplinary diabetes mellitus program, including diabetes education for self-care activities, positively impacts patients, maintaining good outcomes despite lockdown difficulties.

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Authors: Ana Cristina García-Ulloa, Jorge Alberto Ramírez-García, Michelle Díaz-Pineda, Christa Nadine Ovalle-Escalera, Rodrigo Eduardo Arizmendi-Rodríguez, María Luisa Velasco-Pérez, Sergio Hernández-Jiménez. Objective: To investigate whether a peer-support (PS) program at-distance (PSAD) helps maintain metabolic and mental health in patients with a recent diagnosis of type 2 diabetes (T2DM) after a multidisciplinary intervention. Methods: Patients were randomized in PSAD and PS face-to-face groups (PSFF). Leaders were selected if they accomplished the eligibility criteria such as metabolic control and mental health department approval. Results: We included 133 patients divided into three groups, at-distance (n=62), face-to-face (n=59), and leaders (n=12). Patients in the PSFF had higher odds of reaching glycemic targets at three months than PSAD (OR 2.52 95%CI 1.18-5.38, p=0.01) and improved scores in Diabetes Quality of Life Measure (DQoL) and empowerment. Conclusion: PS increases long-term empowerment and decreases problem areas in T2DM, which increases the likelihood of achieving HbA1c target goals, LDL-C control, and promotes weight loss.

Authors: Ana Cristina García-Ulloa, Jorge Alberto Ramírez-García, Michelle Díaz-Pineda, Christa Nadine Ovalle-Escalera, Rodrigo Eduardo Arizmendi-Rodríguez, María Luisa Velasco-Pérez, Sergio Hernández-Jiménez. Objective: To investigate whether a peer-support (PS) program at-distance (PSAD) helps maintain metabolic and mental health in patients with a recent diagnosis of type 2 diabetes (T2DM) after a multidisciplinary intervention. Methods: Patients were randomized in PSAD and PS face-to-face groups (PSFF). Leaders were selected if they accomplished the eligibility criteria such as metabolic control and mental health department approval. Results: We included 133 patients divided into three groups, at-distance (n=62), face-to-face (n=59), and leaders (n=12). Patients in the PSFF had higher odds of reaching glycemic targets at three months than PSAD (OR 2.52 95%CI 1.18-5.38, p=0.01) and improved scores in Diabetes Quality of Life Measure (DQoL) and empowerment. Conclusion: PS increases long-term empowerment and decreases problem areas in T2DM, which increases the likelihood of achieving HbA1c target goals, LDL-C control, and promotes weight loss.