Cargando…
Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy)
Diabetes mellitus (DM) is the leading cause of polyneuropathy in the Western world. Diabetic neuropathy (DNP) is the most common complication of diabetes and is of great clinical significance mainly due to the pain and the possibility of ulceration in the lower limbs. Early detection of neuropathy i...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572367/ https://www.ncbi.nlm.nih.gov/pubmed/31052426 http://dx.doi.org/10.3390/jcm8050598 |
_version_ | 1783427624123498496 |
---|---|
author | Cabré, Juan J. Mur, Teresa Costa, Bernardo Barrio, Francisco López-Moya, Charo Sagarra, Ramon García-Barco, Montserrat Vizcaíno, Jesús Bonaventura, Immaculada Ortiz, Nicolau Flores-Mateo, Gemma Solà-Morales, Oriol |
author_facet | Cabré, Juan J. Mur, Teresa Costa, Bernardo Barrio, Francisco López-Moya, Charo Sagarra, Ramon García-Barco, Montserrat Vizcaíno, Jesús Bonaventura, Immaculada Ortiz, Nicolau Flores-Mateo, Gemma Solà-Morales, Oriol |
author_sort | Cabré, Juan J. |
collection | PubMed |
description | Diabetes mellitus (DM) is the leading cause of polyneuropathy in the Western world. Diabetic neuropathy (DNP) is the most common complication of diabetes and is of great clinical significance mainly due to the pain and the possibility of ulceration in the lower limbs. Early detection of neuropathy is essential in the medical management of this complication. Early unmyelinated C-fiber dysfunction is one of the typical findings of diabetic neuropathy and the first clinical manifestation of dysfunction indicating sudomotor eccrine gland impairment. In order to assess newly developed technology for the measurement of dermal electrochemical conductance (DEC), we analyzed the feasibility and effectiveness of DEC (quantitative expression of sudomotor reflex) as a screening test of DNP in primary health care centers. The study included 197 people (with type 2 diabetes, prediabetes and normal tolerance) who underwent all the protocol tests and electromyography (EMG). On comparing DEC with EMG as the gold standard, the area under the receiver operating characteristic (ROC) curve (AUC, area under the curve) was 0.58 in the whole sample, AUC = 0.65 in the diabetes population and AUC = 0.72 in prediabetes, being irrelevant in subjects without glucose disturbances (AUC = 0.47). Conclusions: In usual clinical practice, DEC is feasible, with moderate sensitivity but high specificity. It is also easy to use and interpret and requires little training, thereby making it a good screening test in populations with diabetes and prediabetes. It may also be useful in screening general populations at risk of neuropathy. |
format | Online Article Text |
id | pubmed-6572367 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-65723672019-06-18 Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy) Cabré, Juan J. Mur, Teresa Costa, Bernardo Barrio, Francisco López-Moya, Charo Sagarra, Ramon García-Barco, Montserrat Vizcaíno, Jesús Bonaventura, Immaculada Ortiz, Nicolau Flores-Mateo, Gemma Solà-Morales, Oriol J Clin Med Article Diabetes mellitus (DM) is the leading cause of polyneuropathy in the Western world. Diabetic neuropathy (DNP) is the most common complication of diabetes and is of great clinical significance mainly due to the pain and the possibility of ulceration in the lower limbs. Early detection of neuropathy is essential in the medical management of this complication. Early unmyelinated C-fiber dysfunction is one of the typical findings of diabetic neuropathy and the first clinical manifestation of dysfunction indicating sudomotor eccrine gland impairment. In order to assess newly developed technology for the measurement of dermal electrochemical conductance (DEC), we analyzed the feasibility and effectiveness of DEC (quantitative expression of sudomotor reflex) as a screening test of DNP in primary health care centers. The study included 197 people (with type 2 diabetes, prediabetes and normal tolerance) who underwent all the protocol tests and electromyography (EMG). On comparing DEC with EMG as the gold standard, the area under the receiver operating characteristic (ROC) curve (AUC, area under the curve) was 0.58 in the whole sample, AUC = 0.65 in the diabetes population and AUC = 0.72 in prediabetes, being irrelevant in subjects without glucose disturbances (AUC = 0.47). Conclusions: In usual clinical practice, DEC is feasible, with moderate sensitivity but high specificity. It is also easy to use and interpret and requires little training, thereby making it a good screening test in populations with diabetes and prediabetes. It may also be useful in screening general populations at risk of neuropathy. MDPI 2019-05-01 /pmc/articles/PMC6572367/ /pubmed/31052426 http://dx.doi.org/10.3390/jcm8050598 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cabré, Juan J. Mur, Teresa Costa, Bernardo Barrio, Francisco López-Moya, Charo Sagarra, Ramon García-Barco, Montserrat Vizcaíno, Jesús Bonaventura, Immaculada Ortiz, Nicolau Flores-Mateo, Gemma Solà-Morales, Oriol Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy) |
title | Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy) |
title_full | Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy) |
title_fullStr | Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy) |
title_full_unstemmed | Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy) |
title_short | Feasibility and Effectiveness of Electrochemical Dermal Conductance Measurement for the Screening of Diabetic Neuropathy in Primary Care. Decoding Study (Dermal Electrochemical Conductance in Diabetic Neuropathy) |
title_sort | feasibility and effectiveness of electrochemical dermal conductance measurement for the screening of diabetic neuropathy in primary care. decoding study (dermal electrochemical conductance in diabetic neuropathy) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572367/ https://www.ncbi.nlm.nih.gov/pubmed/31052426 http://dx.doi.org/10.3390/jcm8050598 |
work_keys_str_mv | AT cabrejuanj feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT murteresa feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT costabernardo feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT barriofrancisco feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT lopezmoyacharo feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT sagarraramon feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT garciabarcomontserrat feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT vizcainojesus feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT bonaventuraimmaculada feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT ortiznicolau feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT floresmateogemma feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT solamoralesoriol feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy AT feasibilityandeffectivenessofelectrochemicaldermalconductancemeasurementforthescreeningofdiabeticneuropathyinprimarycaredecodingstudydermalelectrochemicalconductanceindiabeticneuropathy |