Journal of Diabetes Investigation · Published 2026-06-12 · DOI 10.1111/jdi.70345
Rohan Shah, Rishikesh Behere, Aboli Bhalerao, Sanat Phatak, Alma Baptist, Chinmay S. Marathe, Chittaranjan S. Yajnik
ABSTRACT Background and Aims It is appreciated that current screening tools for diabetic peripheral neuropathy (DPN) often fail to detect early disease. Sudomotor (sweat gland) dysfunction, among the earliest manifestations of DPN, can be measured objectively by the SUDOSCAN® device. We compared SUDOSCAN® with conventional validated screening (Michigan Neuropathy Screening Instrument or MNSI) in type 1 diabetes (T1D). Methods T1D participants (n = 264, 46.2% male, mean age 26.3 years, mean diabetes duration 13.2 years) enrolled in the prospective PICTURE study (Diabetes Unit, KEM Hospital, Pune, India) underwent simultaneous assessments for sudomotor dysfunction (electrochemical skin conductance ESC <60 μS indicating dysfunction) and DPN (MNSI) and were classified as: (a) MNSI abnormal (‘clinical DPN’), (b) MNSI normal, but ESC <60 (‘subclinical DPN) and (c) Both normal (‘no neuropathy’). Results Sudomotor dysfunction was more common than clinical DPN (46.2 vs 22.3%) with a sensitivity of 72.8% and specificity of 61.4% for detecting clinical DPN. Those with sudomotor dysfunction (ESC <60 μS) were 4.3 times more likely to have clinical DPN compared with participants without sudomotor dysfunction (ESC ≥60 μS). Among participants with normal MNSI (i.e., without clinical DPN), subclinical DPN was detected in 38.5% and was associated with younger age, shorter duration of diabetes, anemia, vitamin D deficiency, and microvascular complications. Conclusion Sudomotor testing is an objective and sensitive method for DPN screening in T1D, aiding early detection.
Abstract from DOAJ. Public domain (CC0 1.0).
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Shah, R., Behere, R., Bhalerao, A., et al. (2026). Sudomotor dysfunction in people with type 1 diabetes with and without clinical peripheral neuropathy: A study from Pune, India. Journal of Diabetes Investigation. https://doi.org/10.1111/jdi.70345