The Effectiveness of Neuropad® for Assessing Diabetic Neuropathy
Accurately assessing diabetic autonomic neuropathy is one of the most important things that can be done to prevent diabetes-related lower extremity amputations. The American Diabetes Association Standards of Cares says all individuals with type 1 diabetes for five years or longer and those with type 2 diabetes should be assessed annually for autonomic neuropathy. There are simple, effective tools to complete these assessments, and Neuropad® is one of them.
There are many clinical manifestations of diabetic autonomic neuropathy, including resting tachycardia, orthostatic hypotension and evidence of peripheral dryness or cracking of skin. Sudomotor dysfunction, in particular, has a strong correlation to diabetic neuropathy. Recognition and treatment of autonomic neuropathy can lead to the improvement of symptoms, the reduction of sequelae and an improvement in quality of life.
Early symptoms of autonomic neuropathy are most commonly caused by the involvement of small fibers and lead to pain, burning or tingling. When large fibers are involved, this leads to numbness and loss of protective sensation. Various tests are used to identify small-fiber and large-fiber function and protective sensations. Not only do these tests identify dysfunction, but they predict the risk of future complications as well.
Neuropad®
Neuropad® is the only practical tool for the assessment of sudomotor dysfunction. Neuropad is a simple sweat test that changes color from blue to pink when normal sweating is present. It has been used for many years in Europe to help diagnose autonomic neuropathy of the foot. Patients with high-risk diabetic feet will have an absence of sweat and will therefore not see any change of color of the Neuropad.
It turns out that Neuropad is not only a simple diagnostic method but is also highly accurate. One study of 251 adult type 2 diabetic patients with no peripheral arterial disease or other potential causes of neuropathy were tested for distal symmetric polyneuropathy (DPN) and showed that Neuropad could be used as a triage test for the diagnosis and staging of DPN in patients with type 2 diabetes, prompting referral to specialized care settings1.
Using Neuropad is also a crucial way physicians can help educate patients about their risk of developing life-threatening lower extremity complications. Patient engagement is activated when patients can see their risk factors rather than just hearing about them. Using Neuropad can help spur patients to take action and address their risk factors and overall health.
How Arche Healthcare Can Help
Members of the Arche LEAP Collaborative get Neuropad as part of their Arche CDFE tool kit. For more information about joining the Arche LEAP Collaborative, click here.
1 https://diabetesjournals.org/care/article/34/6/1378/27840/Accuracy-of-the-Neuropad-Test-for-the-Diagnosis-of