Usefulness of sudomotor function assessment in individuals with type-2 diabetes: A case–control study

International audience AbstractBackground Early screening for type 2 diabètes is crucial to prevent complications such as peripheral neuropathy and their detrimental effects on quality of life and morbidity. Sudomotor function assessment may play a pivotai rôle in this regard.Objective The aim of this study was to evaluate the usefulness of sudomotor function assessment, derived from electrochemi- cal skin conductance (ESC) measurement, for the diagnosis of diabètes in patients.Methods This case-control study was conducted at the University Hospital of Lomé in Togo and included 304 people with Diabètes and 475 control subjects. Sudomotor function was assessed in both groups using a single de vice (Sudoscan2, version SU2 01266). The ESC of the left and right hands and feet were measured in each subject and then averaged. A comprehensive examination was performed, and démographie, anthropométrie, and clinical data were collected. Consent was obtained from ail participants.Results The study found that people with Diabètes were significantly older, had a higher body mass index (BMI), and were more frequently male than the control group (médian and [interquartile]: 57 [48-65] vs. 41 [30-52] years, p <0.0001; 27 [24-31] vs. 25 [22-29] kg/m2, p = 0.0042; 28% vs. 14%, p< 0.0001; respectively). Additionally, people with Diabètes had significantly lower averaged hands and feet ESC compared to the control group (hand ESC: 68 [58-75] vs. 57 [47-69] pS, p <0.0001 and foot ESC: 74 [66-80] vs. 62 [45-71], p< 0.0001 respectively). Similar results were found in both men and women across ail âge groups. In multiple linear régression analysis, diabètes was found to be independently associated with lower ESC, even after adjusting for âge, sex, and BMI. The area under the receiver operating characteristic curves for the diagnosis of diabètes were 0.73 (0.68-0.77) and 0.76 (0.71-0.80) for averaged hand and foot ESC, respectively. The identi- fied thresholds of ESC for diabètes détection were 56 pS (sensitivity = 83%, specificity = 34%) and 66 pS (sensitivity = 86%, specificity = 45%) for hands and feet ESC, respectively.Conclusion Sudomotor function is reduced in people with Diabètes, regardless of âge, sex, and BMI. The ESC measurement has good sensitivity and may be useful in screening patients at risk of diabètes, potentially leading to earlier diagnosis. How- ever, further investigation is required to détermine the relevance of systematic ESC measurement in terms of management and risk stratification for these patients.