A Prospective Study on the use of the Indicator Test Neuropad^® for the Early Diagnosis of Peripheral Neuropathy in type 2 Diabetes

Abstract

Aim: The aim of this prospective study was to evaluate the contribution of the indicator test for sudomotor function Neuropad^® to the early diagnosis of peripheral neuropathy in patients with type 2 diabetes mellitus. Included were 109 type 2 diabetic patients (55 men, mean age 56.15±6.14 years), whose initial clinical examination (Neuropathy Disability Score, NDS) was negative for neuropathy. Patients were first examined between January and June 2004 and re-examined 5 years later by the NDS and Neuropad^®. Initially, 70 patients (64.22%) had normal and 39 (35.78%) patients had abnormal Neuropad^® (groups A and B, respectively). NDS was significantly higher in group B on both examinations (p<0.001). On the second examination, 2 patients (2.86%) in group A and 10 patients (25.64%) in group B had developed neuropathy (p=0.001). Neuropad^® had 83.33% sensitivity and 68.04% specificity for neuropathy. There was a modest but significant agreement (kappa=0.259, p<0.001) between Neuropad^® and NDS for neuropathy.

Conclusions: Among type 2 diabetic patients with normal NDS, development of neuropathy is significantly more frequent in those with abnormal Neuropad^®. These results suggest a potential utility of Neuropad^® for the earlier diagnosis of neuropathy in type 2 diabetes.

Key words

diabetes mellitus - diabetic neuropathy - diagnosis - neuropad

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