Uncategorized

04 Oct

Posted at 12:51h in Uncategorized

A recently presented study (in publication) at the NeuroDiab medical conference in Thessaloniki has again demonstrated that Neuropad is a valid and accurate test for the detection of diabetic autonomic neuropathy (DAN). This study shows that Neuropad has a sensitivity of 89% and a specificity of 78% and identical respective positive and negative predictive values for the detection of DAN. Major clinical manifestations of DAN include resting tachycardia, exercise intolerance, orthostatic hypotension, constipation, gastroparesis, erectile dysfunction, sudomotor dysfunction, impaired neurovascular function, ‘brittle diabetes’, and hypoglycaemic autonomic failure. DAN is therefore a serious...

29 Apr

Posted at 10:28h in Uncategorized

This new national guidance for care home operators and their staff has been created by an eminent panel of UK healthcare professionals led by Professor Alan Sinclair FRCP and including Professor Gerry Rayman FRCP who is a well-known and respected expert in diabetic foot disease and pioneer of the ‘Touch the Toes’ Test (TTT) for the detection of sensory neuropathy which is a complementary test to Neuropad. Read the guidance for care home operators. The new guidance includes in Appendix A (pages 14-16) a recommendation for care home staff to screen residents with diabetes at risk...

22 Apr

Posted at 09:04h in Uncategorized

Thousands of lives are being put at risk due to delays and disruption in diabetes care, according to a damning report that warns patients have been “pushed to the back of the queue” during the Covid-19 pandemic. There are 4.9 million people living with diabetes in the UK, and almost half had difficulties managing their condition last year, according to a survey of 10,000 patients by the charity Diabetes UK. More than 60% of them attributed this partly to a lack of access to healthcare, which can prevent serious illness and early...

22 Apr

Posted at 13:19h in Uncategorized

Coronavirus pandemic and autonomic neuropathy as an indicator of a poor outcome from Covid infection This is a recent very useful resource produced by the Foundation for Diabetes Research in Older People & RIA Diabetes and Education concerning the Vascular and Non-Vascular Complications of Diabetes and in this module neuropathy and diabetes-related foot disease in care homes residents. Slide 6 includes information on the Neuropad® test. Read the full article. ...

24 Jan

Posted at 13:20h in Uncategorized

A newly published article critically appraises research and clinical methods for the diagnosis or screening of early DPN. In brief, functional measures are subjective and are difficult to implement due to technical complexity. Moreover, skin biopsy is invasive, expensive and lacks diagnostic laboratory capacity. Indeed, point-of-care nerve conduction tests are convenient and easy to implement however questions are raised regarding their suitability for use in screening due to the lack of small nerve fibre evaluation. The signs and symptoms of DPN are insidious and current screening programmes rely on subjective tests...

12 Nov

Posted at 13:21h in Uncategorized

A new study examines the cost effectiveness of the Neuropad screening test for diabetic neuropathy vs the 10g mononfilament test and also in combination with the 10g monofilament. Compared with standard care, Neuropad, in combination with the 10-g monofilament tool, is the dominant strategy as it leads to higher health gains and lower costs. In practice, compared with using the monofilament alone, performing both tests would lead to a savings of £1049.26 per patient and 0.044 QALY gain. Results were found to be consistent across the sensitivity analyses. The authors concluded that using...

28 Aug

Posted at 13:25h in Uncategorized

As part of its ongoing Neuropad guidance development, the UK National Institute of Health and Care Excellence (NICE) commissioned an Adoption Scoping Report. In the report, NICE asked NHS clinicians who were familiar with the Neuropad test what they thought of it. Amongst the comments received, the principal findings were as follows: ‘Contributors thought that sweat production is a good marker of diabetic peripheral neuropathy. All reported that Neuropad could be used as part of a comprehensive foot assessment and in conjunction with sensory testing.’ Contributors went on to say that: ‘Neuropad...

09 Jul

Posted at 15:02h in Uncategorized

Newly published figures from the NHS England show that the weekly amputation rate has again climbed to now 169 a week and that they still show huge regional variation. This was as true in 2012 as it is today. In 2012 Diabetes UK launched its ‘Putting Feet First’ campaign but what has happened to that initiative? It seems to have all but disappeared now with a focus on blood glucose control rather than the complications associated with it yet the charity has referred to the ever increasing rate of amputations as...

10 Jun

Posted at 15:03h in Uncategorized

Professor Sidney Weinstein(1922-2010), an American neuropsychologist, together with psychologist Dr Josephine Semmes, developed the instrument originally referred to as the Semmes-Weinstein Pressure Aesthesiometer (SWPA), a calibrated series of nylon monofilaments inspired by the Von-Frey horse-hair instrument which permitted the quantification and classification of sensory loss in brain-injured patients. They used the monofilaments to map cortical areas of the brain in monkeys. The initial publication of normative thresholds in human subjects is found in the book Somatosensory Changes After Penetrating Brain Wounds in Man. When the US DuPont company first invented...