SUDOSCAN: A Simple, Rapid, and Objective Method with Potential for Screening for Diabetic Peripheral Neuropathy

Area of Science:

• Neurology
• Diabetology
• Medical Diagnostics

Background:

• Clinical detection of diabetic peripheral neuropathy (DPN) lacks objectivity and reproducibility.
• There is a need for reliable, non-invasive screening tools for DPN in clinical practice.
• Sudomotor function assessment may offer a quantitative approach to DPN detection.

Purpose of the Study:

• To evaluate SUDOSCAN, a novel method for assessing sudomotor function, as a reliable screening tool for DPN.
• To determine the accuracy of SUDOSCAN in identifying DPN and cardiovascular autonomic neuropathy (CAN).
• To assess the correlation between SUDOSCAN measurements and established neurophysiological tests.

Main Methods:

• Seventy subjects (45 with type 1 diabetes, 25 healthy volunteers) were assessed.
• Assessments included clinical evaluation, neurophysiology, cardiovascular reflex tests (CARTs), and SUDOSCAN (Electrochemical Skin Conductance - ESC).
• Subjects were classified into DPN/No-DPN and CAN/subclinical-CAN/no-CAN groups based on established criteria.

Main Results:

• Foot ESC was significantly lower in DPN subjects compared to No-DPN and healthy volunteers (p<0.001), with 87.5% sensitivity and 76.2% specificity for DPN.
• Both foot and hand ESC were significantly lower in subjects with CAN compared to No-CAN and healthy volunteers (p<0.001).
• SUDOSCAN measurements (ESC) showed strong correlations with nerve conduction parameters and CAN composite scores.

Conclusions:

• SUDOSCAN provides a quick, non-invasive, and quantitative assessment of sudomotor function.
• SUDOSCAN demonstrates significant potential as an objective screening test for DPN and CAN in diabetic patients.
• This method can aid in achieving recommended annual DPN assessments in busy diabetic clinics.