Non-invasive and quantitative assessment of sudomotor function for peripheral diabetic neuropathy evaluation

Gin, H.; Baudoin, R.; Raffaitin, C.; Rigalleau, Vincent; González, C.

doi:10.1016/j.diabet.2011.05.003

Cited by 83 publications

(68 citation statements)

References 23 publications

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“…The observed differences between the various reports in the field of diagnostic value of the ESC measurement may result from the methods used to assess neuropathy and different groups of patients. 8,24,28 Similarly to Gin et al 19 and Mayaudon et al, 28 our study showed good reproducibility of the assay.…”

Section: Resultssupporting

confidence: 86%

Evaluation of sudomotor function in adult patients with long lasting type 1 diabetes

Gandecka¹,

Araszkiewicz²,

Piłaciński³

et al. 2017

Polish Archives of Internal Medicine

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INTRODUCTION The function of the sweat glands appears to be impaired in patients with diabetic complications.OBJECTIVES The aim of the study was to evaluate sudomotor function in adult patients with type 1 diabetes (DM1) and healthy controls and its relationship with metabolic control and diabetic complications. .5-78.5 μS), P <0.001). In the study group, there was a negative correlation between ESC and patients' age, duration of diabetes, waist -to -hip ratio, skin autofluorescence, vibration perception threshold, as well as hemoglobin A 1c and triglyceride levels, and a positive correlation with estimated glomerular filtration rate. Microvascular complications were diagnosed in 73.3% of the patients. Patients with retinopathy, diabetic kidney disease, peripheral neuropathy, and cardiac autonomic neuropathy had lower ESC in the feet and hands compared with those without complications. In multivariate logistic regression models, ESC was associated with the presence of any microvascular complications independently of potential confounders.CONCLUSIONS Diabetic microangiopathy, and in particular neuropathy, is related with reduced sudomotor function in DM1. A longer duration of diabetes, worse metabolic control, and reduced renal function are associated with greater sudomotor dysfunction.ORIGINAL ARTICLE Sudomotor function in patients with type 1 diabetes 17 Therefore, the aim of this study was to evaluate sudomotor function using the SUDOSCAN+ device in adult patients with DM1 and healthy controls, as well as to assess the relationship of sudomotor function with metabolic control and diabetic complications. PATIENTS AND METHODS PatientsOur study involved 404 patients (194 women) with DM1, treated at

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Section: Resultssupporting

confidence: 86%

Evaluation of sudomotor function in adult patients with long lasting type 1 diabetes

Gandecka¹,

Araszkiewicz²,

Piłaciński³

et al. 2017

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

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“…8 In a multivariate study, sudomotor function demonstrated larger associations with diabetes-related foot ulcer over monofilament insensitivity, vibration perception threshold, and neuropathy disability scores. 9 The Sudoscan has a low coefficient of variation of 7% at the foot level 11,12 that is 3-and 4-fold lower than Neuropad (22%) and vibration perception threshold testing (33%). 12 Increases in regional foot temperatures have been associated with subsequent ulcer formation with thermal monitoring holding promise for foot ulcer prevention.…”

Section: Discussionmentioning

confidence: 99%

“…9 The Sudoscan has a low coefficient of variation of 7% at the foot level 11,12 that is 3-and 4-fold lower than Neuropad (22%) and vibration perception threshold testing (33%). 12 Increases in regional foot temperatures have been associated with subsequent ulcer formation with thermal monitoring holding promise for foot ulcer prevention. 26 When regional temperature increases are detected, they can be significantly reduced with purposeful cooling.…”

Section: Discussionmentioning

confidence: 99%

A Novel Shear Reduction Insole Effect on the Thermal Response to Walking Stress, Balance, and Gait

Wrobel

Peethambaran

et al. 2014

J Diabetes Sci Technol

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Reducing shear or side-to-side stresses on the plantar surfaces of feet in patients with diabetes is of particular interest lately. Conflicting clinical trial data of custom pressure-reducing footwear suggest that other offloading or footwear approaches may be necessary. 1,2 Gait lab studies suggest shear stresses are in a different location and magnitude versus age-matched controls. 3 Shear stresses in the foot also demonstrate a large association with thermal changes in response to walking in patients with diabetes and peripheral neuropathy. 4 Currently, there are no commercially available products to detect shear inside the shoe. However, relative temperature changes using thermometry may represent antecedent inflammatory changes from shear and pressure occurring prior to clinical expression of foot ulceration at the skin level. Purposeful "cooling" of the foot in clinical trials resulted in effect sizes of 4-to 10-fold reduction in reulceration. 5-7 Autonomic neuropathy can also affect thermoregulation of foot temperature and may be a more sensitive measure 8 for predicting foot ulcer. 9 In this study we measured sudomotor function for small fiber autonomic neuropathy. 10-12 Shear-reducing insoles that permit side-to-side motion in the device to reduce shear at the skin and deeper tissue level may make patients feel unsteady and less confident with walking. Therefore, in this study, we measured gait and balance changes under single and dual task conditions to explore for gait adaptations. In addition, these measurements may 546528D STXXX10.

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“…[8][9][10] This test is based on the electrochemical reaction between the chloride ions in sweat and stainless steel-based plate electrodes, on which the subject's hands and feet are Strelitz Diabetes Center for Endocrine and Metabolic Disorders and the Neuroendocrine Unit, Department of Medicine, Eastern Virginia Medical School.…”

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confidence: 99%

Sudoscan, a Noninvasive Tool for Detecting Diabetic Small Fiber Neuropathy and Autonomic Dysfunction

Casellini

Parson²,

Richardson³

et al. 2013

Diabetes Technology & Therapeutics

251

229

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Objective: Sudomotor dysfunction may be an early detectable abnormality in diabetic small fiber neuropathy. The aim of this study was to evaluate the efficacy of SudoscanÔ (Impeto Medical, Paris, France) in detecting diabetic neuropathy (DN), in comparison with other standardized tests, in patients with diabetes mellitus (DM). Subjects and Methods: Sudoscan measures electrochemical skin conductance (ESC) of hands and feet through reverse iontophoresis. We evaluated 83 DM patients with and without DN and 210 healthy controls (HCs). Neuropathy Impairment Score-Lower Legs (NIS-LL), quantitative autonomic function testing (QAFT), and quantitative sensory testing (QST) were performed. Symptomatic pain was recorded using a visual analog scale. Receiver-operator characteristic (ROC) curves were calculated to evaluate the efficacy of Sudoscan in detecting DN compared with traditional modalities. Results: Diabetes patients with DN had significantly worse ESCs of feet and hands than DM patients without DN and HCs (respectively, 56.3 -3 vs. 75.9 -5.5 and 84.4 -0.9 [P < 0.0001] for feet and 51.9 -2.4 vs. 67.5 -4.3 and 73.1 -0.8 [P < 0.0001] for hands). Increasing NIS-LL scores were associated with decreasing ESC values. ESCs correlated significantly with clinical (NIS-LL), somatic (QST), and autonomic (QAFT) measures of neuropathy and with pain scores. ROC curve analysis showed significant results for both hands and feet ESC (area under the curve of 0.86 and 0.88, respectively; P < 0.0001) with sensitivity of 78% and specificity of 92% for feet to detect DN. Conclusions: Sudoscan is a promising, sensitive tool to detect neuropathy in patients with DM. This is a very simple, easy-toperform test that can be done in the clinical setting in 3-5 min.

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Non-invasive and quantitative assessment of sudomotor function for peripheral diabetic neuropathy evaluation

Cited by 83 publications

References 23 publications

Evaluation of sudomotor function in adult patients with long lasting type 1 diabetes

Evaluation of sudomotor function in adult patients with long lasting type 1 diabetes

A Novel Shear Reduction Insole Effect on the Thermal Response to Walking Stress, Balance, and Gait

Sudoscan, a Noninvasive Tool for Detecting Diabetic Small Fiber Neuropathy and Autonomic Dysfunction

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