Neuropad in the news

Delegates at an international diabetic neuropathy conference heard how a painless home test provides a valid and accurate check for diabetic autonomic neuropathy (DAN). A study presented at the recent NeuroDiab medical conference in Thessaloniki, Greece, shared the results of research into the effectiveness of Neuropad, a non-invasive home test that provides an early warning of diabetes related foot problems. Damage to the nerves in the feet due to diabetes can result in the sweat glands not producing enough moisture, leading to dry and cracked feet. Sudomotor dysfunction is one of the earliest indicators of...

Since 2013/14, there has been a growth in the volume and value of clinical negligence claims involving patients with diabetes-related lower limb complications. The majority of claims have involved patients with a diabetic foot ulcer who went on to undergo a major lower limb amputation. Major amputation is a life changing event for a person with diabetes, but the tragedy is all the greater if it could have been prevented. In such circumstances, at the very least, all possible lessons should be learnt from the circumstances surrounding such amputations and patient...

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...

Diabetic autonomic neuropathy (DAN), an underdiagnosed diabetes complication, is defined as ‘an autonomic nervous system disorder that results from changes caused by diabetes or prediabetes, after exclusion of other possible causes.’ It is due to damage to the small unmyelinated type C nerve fibers, and the clinical picture may vary from subclinical to symptomatic states, requiring specific tests for diagnosis confirmation. Several risk factors have been shown to contribute to DAN development, including diabetes duration, poor glucose control, obesity, dyslipidemia, high blood pressure, and microvascular complications. Gold-standard diagnostic tests for DAN,...

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...

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...

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. ...

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...

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...