Evaluation of a New Indicator Test for Sudomotor Function (Neuropad®) in the Diagnosis of Peripheral Neuropathy in Type 2 Diabetic Patients

Abstract

Use of the new indicator test has a very high sensitivity in detection of diabetic peripheral neuropathy. Sudomotor dysfunction can be demonstrated in a considerable part of patients with normal clinical examination. Time until complete colour change of the indicator test is associated with severity of peripheral neuropathy.

The Diabetic Foot in End Stage Renal Disease

“…[17] A frequently neglected component of neuropathy is diminished sweating, otherwise known as sudomotor impairment. [20,21] This results in dry skin and callus formation, enabling bacteria to enter the skin through fissures and rendering the foot vulnerable to ulceration. [10,20] Finally, poor balance and instability, largely ascribable to a loss of proprioception, predispose one to foot trauma and ulceration.…”

“…[79] Finally, a new simple test measures sweat production by color change of an indicator test applied on the plantar aspect of the foot, thereby additionally evaluating foot skin dryness. [21] In addition, the clinician should meticulously examine the foot for evidence of increased risk. Heavy callus, prominent metatarsal heads, plantar arch collapse, claw or hammer toes, and other deformities, as well as nail pathology (onychomycosis, ingrown nails, paronychia) and skin changes (blisters, fissures etc) should by no means escape notice.…”

Peripheral neuropathy is associated with increased mean platelet volume in type 2 diabetic patients

“…In the present study patients with a DNI score higher than 2 were considered to have peripheral neuropathy [4,7]. Peripheral neuropathy was considered moderate in patients with a DNI score between 2.5 and 4.5 (N ¼ 48) and severe in those with a DNI score between 5 and 8 (N ¼ 33) [7].…”

“…The DNI is a standardized examination of feet appearance (deformity, dry skin, callus, infection and fissures), neuropathic ulceration, Achilles tendon reflexes and vibration perception at great toe using a 128-Hz tuning fork (normal score 2; worst score 8) [4]. In the present study patients with a DNI score higher than 2 were considered to have peripheral neuropathy [4,7]. Peripheral neuropathy was considered moderate in patients with a DNI score between 2.5 and 4.5 (N ¼ 48) and severe in those with a DNI score between 5 and 8 (N ¼ 33) [7].…”

“…Neuropathy was diagnosed by means of the diabetic neuropathy index (DNI) [4,7]. The DNI is a standardized examination of feet appearance (deformity, dry skin, callus, infection and fissures), neuropathic ulceration, Achilles tendon reflexes and vibration perception at great toe using a 128-Hz tuning fork (normal score 2; worst score 8) [4].…”