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Exp Clin Endocrinol Diabetes 2005; 113(4): 195-198
DOI: 10.1055/s-2005-837735
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

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

N. Papanas1 , K. Papatheodorou1 , D. Christakidis2 , D. Papazoglou1 , G. Giassakis3 , H. Piperidou3 , C. Monastiriotis1 , E. Maltezos1
  • 1Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
  • 2Diabetic Department, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
  • 3Department of Neurology, Democritus University of Thrace, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece
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Publication History

Received: May 1, 2004 First decision: June 28, 2004

Accepted: January 8, 2005

Publication Date:
13 May 2005 (online)

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Abstract

Sudomotor neuropathy is associated with reduction of plantar sweating and contributes to the pathogenesis of diabetic foot ulcers. The aim of the present study was to evaluate the new indicator test for sudomotor function (Neuropad®) in the diagnosis of peripheral neuropathy among type 2 diabetic patients. This study included 104 type 2 diabetic patients (51 men) with a mean age of 64.2 ± 5.6 years and a mean diabetes duration of 12.8 ± 3.7 years. Peripheral neuropathy was diagnosed by means of the Diabetic Neuropathy Index (DNI). Sudomotor neuropathy was assessed by means of colour change in the indicator test. Peripheral neuropathy was diagnosed in 71 patients (68.3 %). Sudomotor neuropathy was diagnosed in 67 patients (94.4 %) with peripheral neuropathy and in 10 patients (30.3 %) without peripheral neuropathy (p = 0.0001). Compared with DNI, sensitivity of the indicator test for diagnosing peripheral neuropathy was 94.4 % and specificity was 69.7 %. Overall prevalence of neuropathy was higher using the indicator test (77 patients, 74.0 %) than using the DNI (71 patients, 68.3 %). Time until complete colour change of the indicator test was 23.8 ± 6.7 min in patients with peripheral neuropathy and 7.7 ± 1.2 min in patients without peripheral neuropathy (p = 0.001). Among patients with peripheral neuropathy, time until complete colour change of the indicator test was 14.2 ± 1.9 min in those with a DNI value between 2.5 and 4.5, while it was 32.8 ± 2.6 min in those with a DNI value between 5 and 8 (p = 0.003). Conclusions: 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.

Key words

Diabetes mellitus - diabetic peripheral neuropathy - diabetic foot - sudomotor dysfunction

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Dr. N. Papanas

Ethnikis Antistasis 44

Alexandroupolis 68100

Greece

Phone: + 302551084972

Fax: + 30 25 51 07 47 23

Email: papanasnikos@yahoo.gr