The new indicator test (Neuropad): a valuable diagnostic tool for small-fiber impairment in patients with type 2 diabetes

Diabetes Educ. Mar-Apr 2007;33(2):257-8, 260, 262 passim. doi: 10.1177/0145721707299661.

Abstract

Purpose: The purpose of this study was to evaluate the new indicator test for sudomotor function (Neuropad) in the diagnosis of small-fiber impairment in patients with type 2 diabetes.

Methods: This study included 123 patients with type 2 diabetes (59 men; mean age, 64.3 +/- 8.6 years; mean diabetes duration, 12 +/- 6.1 years). Sudomotor dysfunction was assessed by means of the new indicator test. Neuropathy was diagnosed by the Neuropathy Disability Score and small-fiber impairment by temperature perception (Tiptherm device) and pain perception (Neurotip).

Results: The frequency of sudomotor dysfunction was significantly (P = .001) higher in patients with neuropathy (95%) than in those without neuropathy (30.2%). Sensitivity of the indicator test for neuropathy was 95%, and specificity was 69.8%. Frequency of neuropathy was significantly (P = .018) higher with the indicator test (74.8%) than with conventional clinical examination (65.4%). Sudomotor dysfunction was significantly (P = .001) more frequent in patients with small-fiber impairment (99%) than in those without small-fiber impairment (21.7%). Sensitivity for small-fiber impairment was 99%, and specificity was 78.3%. There was no difference (P = .999) in the frequency of small-fiberimpairment as diagnosed with the indicator test (80.5%) and with clinical examination (81.3%).

Conclusions: The indicator test has a very high sensitivity and specificity for small-fiber impairment in patients with type 2 diabetes.

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Neuropathies / diagnosis*
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers / physiology
  • Reagent Kits, Diagnostic
  • Sensitivity and Specificity

Substances

  • Reagent Kits, Diagnostic