(9.14) Utilization of Sudoscan for early detection of peripheral neuropathy

Sudoscan is an innovative technology to detect peripheral neuropathy. We have conducted a study to determine the role of Sudoscan in the early detection of diabetic peripheral neuropathy.

Methods:

Our study compares patient symptoms of peripheral neuropathy with the result of sudoscan. It is a retrospective study that includes 70 diabetic patients of whom 6 had Type I DM and rest had Type II DM. The average age of study population ranges from 40 to 70 years old, with approximately equal gender distribution.
Suodscan was used as a primary method for annual diabetes peripheral neuropathy screening and was compared to patients' symptoms described in history.

Results: 54 out of 70 patients tested positive for peripheral neuropathy on Sudoscan, 28 of which were asymptomatic at the time of diagnosis, thus can be classified as early diagnosis.

Discussion/Conclusion:

Sudoscan is a quick and non-invasive test that measures sweat gland function. The machine comprises of four electrodes. During the test, patients place their palms and soles on electrodes, and a low electric tension is applied to stimulate sweat glands. The procedure is painless and take less than 3 minutes. Chloride from sweat glands is extracted producing a current, which is proportional to the number of functioning sweat glands.

Sweat glands are innervated by sympathetic C-fibers in the dermis. These nerve fibers are one of the early nerve fibers damaged during diabetic neuropathy, thus co-relating the functionality of sweat glands to diabetic peripheral neuropathy.

The efficiency of Sudoscan is verified in many clinical studies, one of which finds it comparable to the result of skin biopsy with measurement of intraepidermal nerve fiber density.

As traditional methods of diabetes peripheral neuropathy(DPN) screening; the 10g monofilament test and Tuning Fork test come with subjective and objective differences and are not able to detect peripheral neuropathy at earlier stages.

The ability of Sudoscan to be quick, detect disease early and give reproducible results makes it a good resource/alternative to pursue DPN annual screening. It will help ensure adherence to current recommendations of annual assessments for all diabetic patients that remain unfulfilled. 

The provision of quantitative results is another favorable aspect of Sudoscan, as it makes it easier for patients to understand the disease presence and progression, which can possibly help to increase the adherence to diabetes treatment and better foot care.