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The Diabetes Educator, Vol. 33, No. 2, 257-266 (2007)
DOI: 10.1177/0145721707299661
© 2007 American Association of Diabetes Educators; Published by SAGE Publications

TOOL CHEST

The New Indicator Test (Neuropad®)

A Valuable Diagnostic Tool for Small-Fiber Impairment in Patients With Type 2 Diabetes

Nikolaos Papanas, MD, PhD, Konstantinos Papatheodorou, MD, Dimitrios Papazoglou, MD, PhD, Dimitrios Christakidis, MD, Christodoulos Monastiriotis, MD and Efstratios Maltezos, MD, PhD

From the Second Department of Internal Medicine, Democritus University of Thrace, Greece (Dr Papanas, Dr Papatheodorou, Dr Papazoglou, Dr Monastiriotis, Dr Maltezos), and the Diabetic Department, University Hospital of Alexandroupolis, Greece (Dr Christakidis).

Correspondence to Nikolaos Papanas, MD, PhD, Ethnikis Antistasis 44, Alexandroupolis 68100, Greece (papanasnikos{at}yahoo.gr).

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.


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