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January 18, 2026Scientific Reports0 citationsOpen Access

Sudomotor dysfunction reflects early atherosclerosis risk in adults with type 1 diabetes

DNDariusz NaskrętAGAgnieszka Gandecka-PemperaMKMichał Kulecki

Key Result

Sudomotor dysfunction was significantly associated with increased carotid intima-media thickness (0.56 vs 0.54 mm) and higher vascular age (48 vs 42 years) in adults with type 1 diabetes.

Key Points

  • Explore the connection between sudomotor function, carotid intima-media thickness, and vascular age in adults with type 1 diabetes.
  • Cross-sectional analysis of 299 adults with type 1 diabetes.
  • SUDOSCAN was used to measure sudomotor function; carotid intima-media thickness was assessed via ultrasound.
  • Multiple linear regression adjusted for sex, HbA1c, BMI, and creatinine was performed.
  • Participants with sudomotor dysfunction had thicker carotid intima-media thickness (p = 0.04) and higher vascular age (p = 0.04).
  • A negative correlation between Feet ESC and cIMT was found (Rs = -0.22, p < 0.001).
  • Reduced Feet ESC showed a significant association with vascular age (β = 0.13, p = 0.03).

Study Design

Type

Cross-Sectional (n=299)

Multicenter

No

Structured PICO

Does sudomotor dysfunction correlate with increased carotid intima-media thickness and vascular age in adults with type 1 diabetes?

P
Population
299 adults with type 1 diabetes (T1D), aged 34 (IQR: 25-44) years, disease duration 16 (IQR: 11-25) years, and HbA1c of 7.7 (IQR: 7.0-8.7)%. Exclusion criteria: pregnancy, active foot ulceration or limb amputation, ketoacidosis, acute infection, implanted electronic devices, mental and neurological disorder, and diagnosed CVD.
I
Intervention
Sudomotor dysfunction (SMD) defined as Feet electrochemical skin conductance (ESC) < 70 µS measured with the SUDOSCAN device
C
Comparator
Preserved sudomotor function (Feet ESC ≥ 70 µS)
O
Outcome
Carotid intima-media thickness (cIMT) and vascular age (VA)surrogate

Sudomotor dysfunction is associated with increased carotid intima-media thickness and vascular age in adults with type 1 diabetes, suggesting it may serve as an early, non-invasive marker of subclinical atherosclerosis.

Main Result

Absolute Event Rate: 0.56% vs 0.54%

p-value: p=0.04

Limitations

  • No a priori sample size calculation
  • Cross-sectional design does not allow for causal inference
  • Only indirect markers were assessed without confirmation by skin biopsy or neurophysiological testing
  • Lack of standardization across various definitions of cIMT
  • Multicollinearity between age, diabetes duration, hypertension, and electrochemical skin conductance
  • Only indirect markers assessed (no skin biopsy or neurophysiological testing)
  • Clinical utility of cIMT is debated
  • Multicollinearity in the regression model

Abstract

Abstract Adults with type 1 diabetes (T1D) are at increased risk of premature atherosclerosis. Sudomotor dysfunction (SMD), an early manifestation of diabetic neuropathy, may contribute to vascular injury. This cross-sectional study assessed the relationship between sudomotor function (SMF), carotid intima-media thickness (cIMT), and vascular age (VA) in T1D. The study included 299 adults with T1D (137 men), aged 34 (IQR: 25–44) years, disease duration 16 (IQR: 11–25) years, and HbA1c of 7.7 (IQR: 7.0–8.7)%. Sudomotor function was measured with the SUDOSCAN device; abnormal function was defined as Feet ESC < 70 µS (SMD). cIMT was assessed with carotid ultrasound, and VA was derived from cIMT values. Participants with SMD had thicker cIMT 0.56 (IQR: 0.5–0.67) vs 0.54 (0.48–0.52), p = 0.04 and higher VA 48 (36–70) vs 42 (32–58), p = 0.04. We found a negative correlation between Feet ESC and cIMT (Rs = − 0.22, p < 0.001). In a multiple linear regression model adjusted for sex, HbA1c, BMI, and creatinine, reduced Feet ESC remained significantly associated with VA (β = 0.13, p = 0.03), R 2 = 0.065. SMD is associated with increased cIMT and VA in adults with T1D. SMF assessment by SUDOSCAN may represent a rapid, non-invasive tool to identify individuals at higher cardiovascular risk.

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Cite This Study

Naskręt et al. (2026) conducted a cross-sectional in Type 1 Diabetes (n=299). Sudomotor dysfunction (Feet ESC <70 µS) vs. Normal sudomotor function (Feet ESC ≥70 µS) was evaluated on Carotid intima-media thickness (cIMT) in mm (p=0.04). Sudomotor dysfunction was significantly associated with increased carotid intima-media thickness (0.56 vs 0.54 mm) and higher vascular age (48 vs 42 years) in adults with type 1 diabetes.

synapsesocial.com/papers/696c7791eb60fb80d1395d0ahttps://doi.org/10.1038/s41598-026-36292-w
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