Abstract
Sudomotor dysfunction may appear in early stages of diabetic neuropathy. To evaluate the diagnostic capacity of the Neuropad test, based on the detection of sudomotor dysfunction, as an early indicator of diabetic neuropathy. In Forty-two type 2 diabetic patients, the Neuropad test was compared with the 10 g monofilament test (proposed in the technical orientation of diabetic foot of the Ministry of Health of Chile), deep and thermal sensitivity. The surface sensitivity assessed with a brush had a sensitivity and specificity of 18.8 and 100% respectively when compared with the 10 g monofilament. When compared with the Neuropad, the figures were 9 and 100%, respectively. Pain perception sensitivity and specificity were 13 and 100% respectively when compared with the 10 g monofilament. The figures were 6 and 100%, when compared with the Neuropad. Thermal discrimination had a sensitivity and specificity of 88 and 33% respectively when compared with the 10 g monofilament. The figures were 75 and 25% respectively when compared with the Neuropad. The deep sensitivity evaluated with a 128 Hz tuning fork had a sensitivity and specificity of 31 and 100% respectively when compared with the 10 g monofilament. The figures were 16 and 31% respectively when compared with the Neuropad. The Neuropad had a sensitivity and specificity of 94 and 29% respectively were compared with the 10 g monofilament. Neuropad had a good diagnostic yield for the early detection of sudomotor dysfunction.
Highlights
Sudomotor dysfunction diagnostic test for early detection of diabetic neuropathy Background: Sudomotor dysfunction may appear in early stages of diabetic neuropathy
Material and Methods: In Forty-two type 2 diabetic patients, the Neuropad test was compared with the 10 g monofilament test, deep and thermal sensitivity
The surface sensitivity assessed with a brush had a sensitivity and specificity of 18.8 and 100% respectively when compared with the 10 g monofilament
Summary
Municipal de Rancagua, Chile Universidad Católica del Maule. aMagister en Ciencias Médicas. La evaluación de la NPD en la actualidad en Chile, se basa en pruebas que evalúan el estado de fibras nerviosas largas que sólo constituyen el 30% de los nervios periféricos[6], los cuales están protegidos por una vaina de mielina, y se subdividen en α y β, siendo responsables del reflejo aquiliano, del tacto, de la sensibilidad vibratoria y la propiocepción[7]. Neuropad®7,10-13 se presenta como una alternativa diagnóstica que permite la detección precoz de la disfunción sudomotora, como indicador del daño las fibras nerviosas cortas, favoreciendo la detección temprana de una NPD. Objetivo Evaluar la sensibilidad y especificidad diagnóstica del Neuropad®, frente al uso del monofilamento, para determinar cuál prueba presenta la mejor capacidad para la detección de la neuropatía diabética periférica,en pacientes de la Atención Primaria de Salud
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