title: A simple new non-invasive sweat indicator test for the diagnosis of diabetic neuropathy.
abstract: A simple non-invasive indicator test (Neuropad(®)) has been developed for the assessment of sweating and, hence, cholinergic innervation in the diabetic foot. The present review summarizes current knowledge on this diagnostic test. The diagnostic ability of this test is based on a colour change from blue to pink at 10 min, with excellent reproducibility, which lends itself to patient self-examination. It has a high sensitivity (65.1-100%) and negative predictive value (63-100%), with moderate specificity (32-78.5%) and positive predictive value (23.3-93.2%) for the diagnosis of diabetic peripheral neuropathy. It also has moderate to high sensitivity (59.1-89%) and negative predictive value (64.7-91%), but low to moderate specificity (27-78%) and positive predictive value (24-48.6%) for the diagnosis of diabetic cardiac autonomic neuropathy. There are some data to suggest that Neuropad can detect early diabetic neuropathy, but this needs further evaluation. It remains to be established whether this test can predict foot ulceration and amputation, thereby contributing to the identification of high-risk patients.
authors.affiliation: Outpatient Clinic of the Diabetic Foot, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece University of Manchester and Manchester Diabetes Centre, Manchester, UK. papanasnikos@yahoo.gr
authors.forename: N
authors.initials: N
authors.lastname: Papanas
authors.forename: A J M
authors.initials: AJ
authors.lastname: Boulton
authors.forename: R A
authors.initials: RA
authors.lastname: Malik
authors.forename: C
authors.initials: C
authors.lastname: Manes
authors.forename: O
authors.initials: O
authors.lastname: Schnell
authors.forename: V
authors.initials: V
authors.lastname: Spallone
authors.forename: N
authors.initials: N
authors.lastname: Tentolouris
authors.forename: S
authors.initials: S
authors.lastname: Tesfaye
authors.forename: P
authors.initials: P
authors.lastname: Valensi
authors.forename: D
authors.initials: D
authors.lastname: Ziegler
authors.forename: P
authors.initials: P
authors.lastname: Kempler
mesh_terms: D000671:Amputation, Surgical; D015415:Biomarkers / Q000032:analysis; D017719:Diabetic Foot / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007202:Indicators and Reagents / Q000737:chemistry*; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D013542:Sweat / Q000737:chemistry* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D007202:Indicators and Reagents; D011933:Reagent Kits, Diagnostic