Key result
Neuropad demonstrated a diagnostic accuracy of 72.2% for detecting somatic diabetic neuropathy and 62.9% for identifying the foot at risk.
Why the study?
Does the Neuropad test accurately diagnose sudomotor diabetic dysfunction compared to the Neuropathy Disability Score in patients with diabetes?
Cross-Sectional (n=264)
Does the Neuropad test accurately diagnose sudomotor diabetic dysfunction compared to the Neuropathy Disability Score in patients with diabetes?
The Neuropad test is a simple, sensitive tool for detecting sudomotor diabetic neuropathy and identifying patients at higher risk for chronic diabetes complications in clinical practice.
Answers are grounded in this paper and cite their sources.
Neuropad shows moderate accuracy for neuropathy detection; cross-sectional data leaves open its role in sudomotor screening without prospective validation.
AIM: The global spread of diabetes (DM) and the importance of early therapeutic intervention determine the need of simple, inexpensive and sensitive methods for diagnosis of diabetic complications in the general practice. The aim of this study was to assess a new instrument - the plaster Neuropad in diagnosing the sudomotor diabetic dysfunction and to investigate the correlates of Neuropad data with diabetic complications. PATIENTS AND METHODS: In this cross-sectional study participated 264 inpatients (M/F=126/138) with DM type 1/2 (61/203), mean age 55.4+/-12.0 and DM duration of 9.3+/-7.1 years. According to hospital records were registered: anthropometric data; fasting plasma glucose and HbA1c; presence of micro-(retino-, nephro-, neuropathy), and macrovascular (arterial hypertension, coronary artery disease and/or brain vascular disease) complications, and neuropathic symptoms were evaluated. For investigation of somatic DN a modified Neuropathy Disability Score (NDS) and for sudomotor autonomic DN - Neuropad were used. RESULTS: Neuropad showed the highest between-feet correlation of 0.91 compared to all other individual tests and the NDS. Neuropad was able to separate patients in groups with different general risk profile, including age, duration of DM, presence of coronary and/or brain vascular disease, nephropathy, and retinopathy. Moreover, Neuropad differentiated patient groups by their stage of DN, evaluated by symptoms, diagnosis, the individual somatic tests and with the highest significance - by NDS. Most sensitive for detecting DN was NDS > or = 3, followed by Achilles reflexes, vibration perception (128 Hz tuning fork) and Neuropad. A borderline or abnormal result of Neuropad showed sensitivity=76.3/79.3, specificity=56.1/42.9, positive=86.3/62.8 and negative=39.5/63.0 predictive values, and diagnostic accuracy 72.2/62.9%, compared to the indices for presence of somatic DN (NDS > or = 3)/foot at risk (NDS > or = 6) respectively. CONCLUSIONS: Screening for DN must cover somatic and autonomic disturbances. Neuropad is a new sensitive and appropriate for everyday clinical use test for detecting sudomotor DN and identification of patients at higher risk for chronic diabetes complications.
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Kamenov et al. (2010) conducted a cross-sectional in Diabetes Mellitus (n=264). Neuropad vs. Neuropathy Disability Score (NDS) was evaluated on Diagnostic accuracy for presence of somatic DN (NDS ≥ 3) and foot at risk (NDS ≥ 6). Neuropad demonstrated a diagnostic accuracy of 72.2% for detecting somatic diabetic neuropathy and 62.9% for identifying the foot at risk.
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