May 6 2013
Details of a new method to detect diabetic neuropathy in patients in less than five minutes using their sweat glands was presented today at the American Association of Clinical Endocrinologists (AACE) 22nd Annual Scientific and Clinical Congress in Phoenix, Arizona by Aaron I. Vinik, M.D., Ph.D., F.C.P., M.A.C.P., F.A.C.E., Professor of Medicine and Director of Research and the Neuroendocrine Unit at Eastern Virginia Medical School.
The method, which has been recently approved by the Food and Drug Administration (FDA), identifies sweat dysfunction in the hands and feet by measuring the skin conductance response through the sweat glands. This device also helps diagnose what type of diabetic neuropathy they have, which can guide the treatment.
More than half of the people with diabetes will develop diabetic neuropathy. Diabetic Neuropathy is nerve damage as a result of diabetes and may lead to loss of feelings in hands, arms, toes and feet. Many patients who have had diabetes for several years and are in the advanced stages of neuropathy will have nerve damage that is almost impossible to reverse. This can cause loss of feeling in the feet which makes it difficult for a diabetic to detect pain or discomfort. This can lead to the development of foot ulcers and increase the risk of amputation.
“It’s important that diabetics are tested for diabetic neuropathy the first time they visit their endocrinologist. People with Type 1 diabetes should be tested again in five years because that is when signs of diabetic neuropathy appear and then continue yearly testing. People with Type 2 diabetes should start their testing right away and then continue yearly,” said Dr. Vinik.
Dr. Vinik said that people have wanted to measure sweat glands for a long time. In the past, a biopsy of the skin to detect diabetic neuropathy was the norm and was invasive, and currently used techniques which measure sweat volume are a tedious process that lasts from 30 minutes to an hour and requires specialized training.
“The new device takes three to five minutes to detect,” said Dr. Vinik. “The new method requires no special skills and has a sensitivity of 80% and specificity of 90% for diagnosing peripheral neuropathy. This new test should be a welcome addition to our means of detecting neuropathy, identifying patients at risk for foot ulcers and amputations, as well as falling and fractures and allow early prevention and intervention to avoid these untoward effects of neuropathy,” said Dr. Vinik.
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