The article titled “Neuropad for the detection of cardiovascular autonomic neuropathy in patients with type 2 diabetes” (Mendivil et al., 2016) discusses the prevalence and impact of cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes. The authors evaluate the use of the Neuropad® test, which measures sudomotor function, as a screening tool for CAN in patients with type 2 diabetes in Bogotá, Colombia.
In this cross-sectional study involving adults with type 2 diabetes, researchers evaluated Neuropad as a screening tool for cardiovascular autonomic neuropathy (CAN). While CAN is conventionally assessed through complex cardiovascular reflex tests, sudomotor impairment often parallels its earliest stages. The study’s objective was to determine whether Neuropad could serve as a pragmatic proxy for CAN detection in a real-world clinic setting.
Participants received the Neuropad plaster on the plantar surface and had their colour response (from blue to pink) evaluated after ten minutes. An “abnormal” colour outcome-indicative of impaired sweating-was then analysed alongside standard CAN metrics derived from heart rate variability and other autonomic parameters.
The results were compelling: an abnormal Neuropad response demonstrated substantial correlation with CAN presence, effectively differentiating between patients with and without autonomic dysfunction. Although not a replacement for gold-standard autonomic reflex testing, Neuropad proved to be a highly sensitive and accessible tool, offering reliable initial screening potential. Its low cost, simplicity, and minimal training requirements make it well-suited for routine use in general practice and diabetic foot clinics, especially in low-resource contexts. The plaster’s performance underscores sudomotor dysfunction as an early and clinically meaningful manifestation of autonomic compromise in diabetes.
In essence, Mendivil et al. illustrate that Neuropad transcends its original design for peripheral neuropathy screening to function as a viable, user-friendly proxy for early CAN detection. By capturing sweat-gland autonomic impairment-an early harbinger of broader autonomic disruption-Neuropad offers clinicians a low-threshold, bedside tool.
With its demonstrated sensitivity and simplicity, the test is poised to enhance early identification of autonomic neuropathy, streamline referrals, and ultimately support timely intervention strategies in diabetic care.