Exp Clin Endocrinol Diabetes 2015; 123(01): 34-38
DOI: 10.1055/s-0033-1357128
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Non-invasive Screening of Diabetes Risk by Assessing Abnormalities of Sudomotor Function

G. Müller
1  University Clinic Carl Gustav Carus at the Technical University Dresden, Germany
,
J. Olschewski
1  University Clinic Carl Gustav Carus at the Technical University Dresden, Germany
,
T. Stange
1  University Clinic Carl Gustav Carus at the Technical University Dresden, Germany
,
V. T. Hjellset
2  University of Oslo, Institute of General Practice and Community Medicine, Department of Preventive Medicine and ­Epidemiology, Oslo, Norway
,
S. Bornstein
1  University Clinic Carl Gustav Carus at the Technical University Dresden, Germany
,
P. E. H. Schwarz
1  University Clinic Carl Gustav Carus at the Technical University Dresden, Germany
3  Paul Langerhans Institute Dresden, German Center for Diabetes Research (DZD), Dresden, Germany
› Author Affiliations
Further Information

Publication History

received 03 July 2013
first decision 03 September 2013

accepted 10 September 2013

Publication Date:
05 May 2014 (online)

Abstract

Background:

The early detection of diabetes, and subsequent lifestyle intervention, may reduce the burden of diabetes and its complications. Several studies have identified a link between sudomotor dysfunction, insulin resistance, and pre-diabetes. The aim of this study was to evaluate the ability of a new non-invasive device EZSCAN evaluating sudomotor function to detect pre-diabetes in a German population at risk for diabetes.

Methods and findings:

200 German subjects at risk for diabetes (mean age 56±14 years, BMI 28.4±5.4 kg/m2) were measured for anthropometric data on inflammatory parameters, including high sensitivity C reactive protein (hs-CRP). The subjects also underwent an oral glucose tolerance test with measurements of plasma glucose, insulin, proinsulin, C-peptide and free fatty acids during 2 h following glucose challenge. Indexes for sensitivity to insulin were calculated: SI using minimal model, HOMA-IR and Matsuda index. Based on the measurement of electrochemical sweat conductance, subjects were classified as no risk, moderate risk or high risk. According to this risk model classification, a significant difference was observed between OGTT-1 h (p=0.004), AUC glucose (p=0.011), AUC C-peptide (p<0.001), HOMA-IR (p=0.009), Matsuda (p=0.002), SI (p<0.001) and hs-CRP (p=0.025) after adjustment for age. Among the 54 subjects with impaired fasting glucose or impaired glucose tolerance according to WHO classification, 37 had a moderate risk and 15 a high risk according to the EZSCAN risk model classification. Among the 12 subjects with newly diagnosed diabetes, 2 had a moderate risk and 10 a high risk according to the risk model classification. No adverse event was reported during or after the study.

Conclusions:

These results, in accordance with a previous study performed in India, show that EZSCAN could be developed as a screening tool for diabetes risk, and could help to improve diabetes screening strategies. Results obtained from an at-risk population would have to be confirmed in a larger population.