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



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).



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%).



The indicator test has a very high sensitivity and specificity for small-fiber impairment in patients with type 2 diabetes.
Papanas
Nikolaos
N
The Second Department of Internal Medicine, Democritus University of Thrace, Greece (Dr. Papanas, Dr. Papatheodorou, Dr. Papazoglou, Dr. Monastiriotis, Dr. Maltezos)
Papatheodorou
Konstantinos
K
The Second Department of Internal Medicine, Democritus University of Thrace, Greece (Dr. Papanas, Dr. Papatheodorou, Dr. Papazoglou, Dr. Monastiriotis, Dr. Maltezos)
Papazoglou
Dimitrios
D
The Second Department of Internal Medicine, Democritus University of Thrace, Greece (Dr. Papanas, Dr. Papatheodorou, Dr. Papazoglou, Dr. Monastiriotis, Dr. Maltezos)
Christakidis
Dimitrios
D
Diabetic Department, University Hospital of Alexandroupolis, Greece (Dr. Christakidis)
Monastiriotis
Christodoulos
C
The Second Department of Internal Medicine, Democritus University of Thrace, Greece (Dr. Papanas, Dr. Papatheodorou, Dr. Papazoglou, Dr. Monastiriotis, Dr. Maltezos)
Maltezos
Efstratios
E
The Second Department of Internal Medicine, Democritus University of Thrace, Greece (Dr. Papanas, Dr. Papatheodorou, Dr. Papazoglou, Dr. Monastiriotis, Dr. Maltezos)
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000502:physiology; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity
D011933:Reagent Kits, Diagnostic