Feasibility and effectiveness of electrochemical dermal conductance measurement for the screening of diabetic neuropathy in primary care. DECODING Study (Dermal Electrochemical Conductance in Diabetic Neuropathy). Rationale and design

Cabré, J.J.; Mur, Teresa; Costa, Bernardo; Barrio, Francisco; López-Moya, Charo; Sagarra, Ramon; García-Barco, Montserrat; Vizcaíno, Jesús; Bonaventura, Immaculada; Ortiz, Nicolau; Flores-Mateo, Gemma

doi:10.1097/md.0000000000010750

Cited by 2 publications

(3 citation statements)

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“…The study design has been extensively described elsewhere [29]. In brief, this was a prospective study aimed at evaluating (a) the feasibility of the protocol in primary care and (b) the capacity of achieving early diagnosis of PN.…”

Section: Methodsmentioning

confidence: 99%

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Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy)

Vila

Mur

Costa

et al. 2019

JCM

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Diabetes mellitus (DM) is the leading cause of polyneuropathy in the Western world. Diabetic neuropathy (DNP) is the most common complication of diabetes and is of great clinical significance mainly due to the pain and the possibility of ulceration in the lower limbs. Early detection of neuropathy is essential in the medical management of this complication. Early unmyelinated C-fiber dysfunction is one of the typical findings of diabetic neuropathy and the first clinical manifestation of dysfunction indicating sudomotor eccrine gland impairment. In order to assess newly developed technology for the measurement of dermal electrochemical conductance (DEC), we analyzed the feasibility and effectiveness of DEC (quantitative expression of sudomotor reflex) as a screening test of DNP in primary health care centers. The study included 197 people (with type 2 diabetes, prediabetes and normal tolerance) who underwent all the protocol tests and electromyography (EMG). On comparing DEC with EMG as the gold standard, the area under the receiver operating characteristic (ROC) curve (AUC, area under the curve) was 0.58 in the whole sample, AUC = 0.65 in the diabetes population and AUC = 0.72 in prediabetes, being irrelevant in subjects without glucose disturbances (AUC = 0.47). Conclusions: In usual clinical practice, DEC is feasible, with moderate sensitivity but high specificity. It is also easy to use and interpret and requires little training, thereby making it a good screening test in populations with diabetes and prediabetes. It may also be useful in screening general populations at risk of neuropathy.

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Section: Methodsmentioning

confidence: 99%

“…This has been described previously elsewhere [29]. In brief, a three-step procedure was carried out to obtain the study data:…”

Section: Methodsmentioning

confidence: 99%

Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy)

Vila

Mur

Costa

et al. 2019

JCM

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show abstract

“…18,69 The skin biopsy was evaluated for assessment of nerve fiber density and dermal nerve bundles. 18,70,71 According to the results obtained from human diabetic skin samples, not only fewer, but fragmented nerves were observed within the dermis, and a reduced amount of nerve afferents was observed within the epidermis. 71 In addition, a tight connection between innervation abnormalities, deficits in VEGFR-expressing dermal blood vessels, and low-grade inflammatory cell infiltration were found.…”

Section: ))mentioning

confidence: 99%