The paper entitled “Advantages of early diagnosis of diabetic neuropathy in the prevention of diabetic foot ulcers” (Sanz-Corbalán et al., 2018) discusses the usefulness of the sudomotor function test (SFT) as a clinical tool in the risk stratification of diabetic patients, and its ability to detect the risk of developing diabetic foot ulcers (DFU) earlier than standard clinical tests.
Results of the study
This prospective follow-up study followed 263 diabetic patients without an active diabetic foot ulcer (DFU) over a period of 3.5 years. Patients were classified according to the International Working Group Risk Stratification System (RSS) based on the results of the Semmes-Weinstein Monofilament Examination (SWME) and biothesiometer measurements or the SFT. The main outcome evaluated was the development of the diabetic foot ulcer.
The results showed that the SFT correctly categorised all patients who developed a diabetic foot ulcer (DFU) according to their risk group, with 100% sensitivity and 31.53% specificity.
In comparison, the SWM and biothesiometer approach had a sensitivity of 83.33% and a specificity of 50.47%.
The respective diagnostic accuracy of the two methods was evaluated using the AUC values, which were as follows:
| Test | Area Under Curve (AUC) values |
|---|---|
| Semmes-Weinstein Monofilament Examination / biothesiometer | 0.776 |
| Sudomotor Function Test | 0.816 |
Based on these findings, the authors conclude that the Sudomotor Function Test improved the risk stratification of diabetic patients in a specialised diabetic foot unit and accurately categorised patients according to their risk of developing DFU. This suggests that early detection of neuropathy using the SFT can help in the prevention of DFU.
Link to abstract
Advantages of early diagnosis of diabetic neuropathy in the prevention of diabetic foot ulcers (Sanz-Corbalán et al., 2018)