Diabetic neuropathies

Diabetic neuropathy is multifactorial and comprises:

Motor neuropathy

Sensory neuropathy

Autonomic neuropathy

The neuropad® test

Pink (normal result)

Feet are sufficiently moist and soft.

Blue/Pink (positive for anhydrosis)

Sudomotor dysfunction detected. Evidence of small fibre denervation and of autonomic neuropathy. If home testing, report findings to your healthcare team. Start daily treatment with neuropad® foot repair foam.

Blue (positive for anhydrosis) sudomotor dysfunction detected.

Evidence of small fibre denervation and of autonomic neuropathy. If home testing, report findings to your healthcare team. Start daily treatment with neuropad® foot repair foam.

The pathway to foot ulceration

A combination of risk factors may ultimately lead to skin breakdown through lack of sweating, leading to dry skin and callus build up. When skin becomes too dry it may crack, resulting in the formation of fissures. Fissures may harbour bacteria and opportunistic infections may develop. If left untreated, these localized infections may cause ulceration which may be difficult to treat. Ultimately, if left untreated or if treatment fails, ulceration may lead to amputation of the affected area.

Diabetic foot syndrome and small fibre neuropathy

Small fibres constitute 70-90% of peripheral nerve fibres and regulate several key functions such as tissue blood flow, temperature and pain perception as well as sweating, all of which are highly relevant to the clinical presentation and adverse outcomes associated with foot ulceration in people with diabetes.4 A positive neuropad® test response indicates both functional and structural denervation in the feet of diabetic patients. This has considerable clinical relevance in screening for diabetic neuropathy.5

PUBLISHED CLINICAL STUDIES LIST

References

1. Tentolouris N, Voulgari C, Liatis S, Kokkinos A, Eleftheriadou I, Makrilakis K, Marinou K, Katsilambros N. Moisture status of the skin of the feet assessed by the visual test Neuropad correlates with foot ulceration in diabetes. Diabetes Care. 2010 May;33(5):1112-4.

2. Malik R, Veves A, Tesfaye S, Smith G, Cameron N, Zochodne D, Lauria G. On behalf of the Toronto Consensus Panel on Diabetic Neuropathy. Small Fibre Neuro¬pathy: Role in the Diagnosis of Diabetic Sensorimotor Polyneuropathy. Diabetes Metabo¬lism Research and Reviews. Res Rev. 2011 Jun 22. doi: 10.1002/dmrr.1222.

3. Malik R. Neuropad: early diagnostic test for diabetic peripheral neuropathy. Prescriber 19 November 2008.

4. Malik R, Veves A, Tesfaye S, et al  on behalf of the Toronto Consensus Panel on Diabetic Neuropathy. Small Fiber Neuropathy: Role in the diagnosis of Diabetic Sensorimotor Polyneuropathy. Diabetes Metabolism Research and Reviews. 2011: 22;1002-1222.

5. Quattrini C, Jeziorska M, Tavakoli M, Begum P, Boulton AJM and Malik RA. The neuropad test: a visual indicator test for human diabetic neuropathy. Diabetologia 2008: 51;6.