23 Apr 2025
Purpose
This study, undertaken by the Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, aimed to evaluate how metabolic indicators impact plantar sudomotor function. It also investigated the associations between both metabolic and non-metabolic factors and sudomotor function using the Neuropad test.
Methods
A total of 481 adult participants were enrolled and stratified into four groups based on blood glucose levels: normoglycaemia, prediabetes, newly diagnosed diabetes, and previously diagnosed diabetes. Sudomotor function was assessed using the Neuropad, which provides both qualitative and quantitative data on sweat gland activity. The colorimetric response of the Neuropad was analysed using specialized colour analysers to determine the degree of function.
In addition to sudomotor assessment, data were collected on several health indicators, including age, body mass index (BMI), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), blood pressure, lipid profiles, and liver and kidney function markers.
Results
Participants with previously diagnosed diabetes showed a significantly reduced slope in sudomotor response (6.96) compared to those with normoglycemia (8.73), indicating diminished sweat gland activity. Furthermore, the prevalence of incomplete colour change on the Neuropad—suggestive of impaired sudomotor function—was markedly higher in the previously diagnosed diabetes group (71.11%) compared to the normoglycaemic group (49.01%).
Multivariable analysis revealed that previously diagnosed diabetes independently predicted reduced sudomotor function. Elevated levels of FPG and HbA1c were associated with decreased sudomotor activity. Additionally, factors such as increased age, higher BMI, alcohol consumption, lower albumin levels, and reduced estimated glomerular filtration rate (eGFR) were also significantly linked to sudomotor dysfunction.
Conclusion
The findings suggest a progressive decline in sudomotor function with rising blood glucose levels. Individuals with previously diagnosed diabetes are at particularly high risk for sudomotor impairment. These results underscore the need for further research into the role of sudomotor dysfunction in the early stages of diabetes and its potential contribution to the development of diabetic complications.
Discussion
Sudomotor dysfunction is one of the earliest signs of autonomic neuropathy, and may occur even in the prediabetic stage. This study highlights how various factors—including ageing and deteriorating metabolic health—can contribute to the decline in sweat gland function. The Neuropad offers a cost-effective and non-invasive method for detecting sudomotor abnormalities, making it a valuable tool for early intervention in the management of diabetes and its associated complications.
Original article
The original article is available here on the Dovepress website.