Neuropad® 10-Minute Screening Test
A guide for health care professionals
Neuropad® is a simple, patented, at-home or in-clinic 10-minute screening test for the early detection of diabetic foot problems (peripheral autonomic neuropathy).
It is a non-invasive, painless test and has been widely studied.
Neuropad® helps you avoid serious complications through early detection
Over 70,000 people in the UK have a foot ulcer at any one time. The cost of treating a foot ulcer for one year is a staggering £7,000.1
Our NHS spends over £700 million per year on treating foot ulcers and performing amputations. And that excludes knock-on social and economic costs.
Dryness of the skin of the feet assessed by the Neuropad® screening test correlates with the potential for foot ulceration.2
What this means is that Neuropad® may pick up diabetes-related foot problems early, so that more serious complications may be avoided through timely treatment.
How Neuropad® detects the symptoms of early diabetic neuropathy
Autonomic dysfunction (like sweat loss) may precede or occur simultaneously with early sensory neuropathy, especially in small-fibre neuropathy. Small unmyelinated C fibres and thinly myelinated A-delta fibres are more vulnerable early in diabetic neuropathy and these control autonomic functions, such as sweating. While sensory symptoms are more obvious and commonly reported, autonomic changes like sweat loss may be subtle but occur early – Neuropad® 10-Minute Screening Test® helps to ensure that the opportunity to detect early and act decisively is not missed.
| Function | Autonomic | Sensory | Motor | |||
|---|---|---|---|---|---|---|
| Myelination | Thinly myelinated | Unmyelinated | Myelinated | Thinly myelinated | Unmyelinated | Myelinated |
| Nerve type | A delta | C | A alpha / beta | A delta | C | A alpha |
| Nerve size |
|
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| Body function | Heart rate, blood pressure, sweating, GIT, GUT function | Touch vibration, position, perception | Cold perception, pain | Warm perception, pain | Muscle control | |
| Diagnostic tool |
|
128 Mhz tuning fork 10g monofilament |
Pressure Stat Tendon reflexes |
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Neuropad® is an evidence-based medical device
Neuropad® has been studied extensively
A study involving 379 patients with diabetes has shown that dryness of the skin of the feet correlates with foot ulceration2.
Subclinical sudomotor dysfunction can be detected early in diabetes, even in subjects with normal nerve conduction velocities.
This study showed that:
- dryness of the skin of the feet was detected in 95% of the patients with foot ulceration using the Neuropad® test.
- an abnormal Neuropad® response correlated with foot ulceration in subjects with diabetes
- patients with foot ulceration had more severe peripheral neuropathy and more often an abnormal Neuropad® response.
Multivariate statistical analysis demonstrated that patients with diabetes with an abnormal Neuropad® response are 16 times more likely to develop foot ulceration compared to those with a normal Neuropad® test result2.
The Neuropad® screening test has what is known as HIGH SENSITIVITY. In clinical trials, the sensitivity and specificity of Neuropad® was comparable to that of well-established hospital-based tests.
Neuropad® is a categorical non-subjective test
Having a high sensitivity means that when the test is carried out a high proportion of people tested have a positive result subsequently confirmed by hospital-based tests. In clinical studies, this has ranged from 70%-86%. In line with most screening tests, Neuropad® has a lower rate of specificity (the proportion of people with a negative result who do not have peripheral autonomic neuropathy) which is typical for a screening test.
The principle behind the Neuropad® screening test is that it may detect potential problems several years before conventional tests for peripheral autonomic neuropathy are able to. This is because only when damage to the small and large nerve fibres in your feet has affected your ability to feel sensation – for example when prodded with monofilament or put into direct content with a tuning fork – will problems be detectable.
Of course monofilament and tuning fork tests are subjective, whereas Neuropad®, on the other hand, is not a subjective test but is categorical.
A video introduction for healthcare professionals
Dr Sarah Jarvis MBE introduces the Neuropad® 10-Minute Screening Test®: ‘the canary in the coal mine’ – a simple, painless, non-invasive and objective test for the early identification of diabetes related foot problems.
Prevention is always better than cure.
Neuropad® 10-minute screening test® updates
Neuropad® reveals sudomotor decline linked to blood sugar and metabolic health
Simple plaster test could save people with diabetes from amputations
Latest study demonstrates sensitivity and accuracy of Neuropad®
Validation of Neuropad® as a test for autonomic neuropathy
Autonomic neuropathic symptoms in patients with diabetes: practical tools for screening in daily routine
Neuropad® assists in ascertaining presence of peripheral small fibre autonomic dysfunction and to identify preulcerative foot lesions in people with diabetes
Neuropad® 10-Minute Screening Test® recommended for use in a care home setting
Neuropad® and clinical guidelines align to enhance early detection of diabetic peripheral neuropathy
NICE to review its existing Neuropad® guidance
