The role of Sudoscan feet asymmetry in the diabetic foot |
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Affiliation: | 1. Clinic of Endocrinology, University Hospital “Alexandrovska”, Medical University – Sofia, Sofia, Bulgaria;2. Clinic of Neurology, University Hospital “Alexandrovska”, Medical University – Sofia, Sofia, Bulgaria;3. Clinic of Septic Surgery, Pirogov Hospital, Sofia, Bulgaria;1. Department of Internal Medicine, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Sao Paulo, Brazil;2. Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, Sao Paulo, Brazil;3. Department of Social Medicine, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Sao Paulo, Brazil;4. Viana Health Center, Aruba;1. Endocrinology and Nutrition Department, Ciudad Real General University Hospital, C/Obispo Rafael Torija, s/n. Ciudad Real, 13005, Spain;2. Córdoba University, Avd. Medina Azahara. 5, Córdoba, 14071 Spain;1. Specialist Training Programme in Family Medicine, Birkirkara Health Centre, Birkirkara, Malta;2. Faculty of Medicine & Surgery, Biomedical Sciences Building, University of Malta, Msida, Malta;3. Division of Diabetes and Endocrinology, University of Malta Medical School, Mater Dei Hospital, Msida, Malta;1. Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium;2. Scientific Institute for Quality in Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands;1. Department of Medical Science, Respiratory Medicine and Allergology, Clinical Chemistry and Asthma Research Centre, Uppsala University and University Hospital, Uppsala, Sweden;2. Department of Microbiology/Immunology, College of Medicine, University of Sulaimani, Sulaimani, Iraq;3. Department of Clinical Biochemistry, College of Pharmacy, University of Sulaimani, Iraq;4. Department of Biology, College of Science, University of Sulaimani, Iraq;5. Department of Medicine, College of Medicine, University of Sulaimani, Sulaimani, Iraq;6. College of Veterinary Medicine, University of Sulaimani, Sulaimani, Iraq |
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Abstract: | The aim of this study was to investigate the role of Sudoscan asymmetry parameters in the diabetic foot.Patients and methodsIn this study we included 165 participants: 84 type 2 diabetes patients divided into three HbA1c matched groups – group 1: newly diagnosed diabetics (n = 31), group 2: people with longer diabetes duration and established neuropathy (n = 33), group 3: patients with diabetic foot ulcer (n = 20), and a control group of 81 people with prediabetes. All subjects underwent peripheral sudomotor evaluation using Sudoscan device (Impeto Medical, Paris).ResultsPatients with diabetic foot had significantly higher Sudoscan feet asymmetry (19.6%) compared to those with only diabetic neuropathy (7.9%), compared to the group with newly diagnosed diabetes (7.44%), and compared to controls (2.5%). This test has shown a good discriminative value (with a threshold of 9.5%) for diabetic foot with area under the ROC curve of 0.955 (p = 0.001). Additionally, in a regression model feet asymmetry proved its predictive value for participants with diabetic foot.ConclusionIn this study Sudoscan feet asymmetry proved to be a novel discriminator and predictor for diabetic foot patients. It might be considered as a marker for early damage in the neuropathy evaluation protocol. |
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Keywords: | diabetic foot sudomotor evaluation neuropathy |
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