Summary: Diabetic neuropathy is a serious chronic complication of diabetes. However, it is highly challenging to diagnose in its early stages. Thus, many people are diagnosed in the later stages, and preventing its progress or treating it isn’t easy. Hence, researchers at Cruzeiro do Sul University in São Paulo, Brazil, came up with the idea of a simple device for diagnosis of early signs of diabetic neuropathy. They found that those living with diabetes apply less force to hold objects. Hence, measuring this force could be a way to diagnose neuropathy early.
More than 10% of people in the US are living with diabetes. It is a chronic metabolic disorder. There is no cure for the condition, though one can manage it quite well in most cases. Many people living with diabetes develop so-called chronic complications like vascular diseases and neuropathies.
It seems that neuropathy occurs almost in all people affected by diabetes, early or later, though it is diagnosed only in a small number of cases. It remains undiagnosed in most individuals, as diagnosing mild neuropathy or diagnosing it in its early stages requires the use of special equipment or tests.
In most people, neuropathy is diagnosed in the later stages of diabetes. As such, diabetic neuropathy causes loss of sensation in the hand or feet, tingling sensation, or even pain. Diabetic neuropathy pain treatment is one of the biggest challenges. In many cases, medications do not provide sufficient relief. Moreover, doctors do not know why neuropathy occurs in those living with diabetes. It seems to happen both due to vascular issues and direct damage to nerves due to metabolic changes in the body.
Since the condition is difficult to treat and almost impossible to reverse, its early diagnosis can help. However, there are currently no biomarkers or tests for its early diagnosis. But it seems that researchers at Cruzeiro do Sul University in São Paulo, Brazil, have found a simple way to diagnose neuropathies in their early stages.
It is a simple piece of equipment that measures the grip strength or how much force one applies to hold anything or manipulate various equipment. It appears that measuring it may not only help diagnose diabetic neuropathy early but also help understand the severity of other neurodegenerative disorders. For example, researchers found that those living with conditions like Parkinson’s, multiple sclerosis, and other neurological diseases apply more strength to hold items than is required. So, they try to compensate this way for the weakness.
Measuring how much force one applies to hold anything is simple. Doctors ask a person to use minimum force on an object and hold it for a few seconds, and then they ask a person to loosen the grip and let the object fall gradually.
Normal people are well aware of the force needed for holding any object. This calculation happens through sensory inputs taken by the spine to the brain, and then the brain sends the command to apply a specific force. Most healthy people use 100-120% of the power to hold objects. Thus, they apply only a bit more pressure than needed to hold that object, thus conserving energy.
However, people with neurodegenerative disorders like Parkinson’s apply far more force to hold objects, as they have sensory pathways and brain issues, too. Thus, they try to compensate for those deficiencies by using more power.
Interestingly enough, they found that, unlike in neurodegenerative disorders, those living with diabetes apply less force to hold and manipulate objects.
The study was done on 36 individuals. Out of them, 12 were healthy control subjects, 12 were living with diabetes but not diagnosed with neuropathy, and the rest of the 12 were living with diabetes and diabetic neuropathy. They were all told to manipulate the object fitted with sensors.
Interestingly, doctors found that even those living with diabetes and still not diagnosed with neuropathy used less force to hold things and carry out manipulations. It means that though they were not diagnosed with neuropathy using traditional tests, they already had some early signs, as confirmed by this simple test.
There are many reasons why people living with diabetes have a weaker grip or apply less force to manipulate instruments. Firstly, they have issues with sensory neurons, and thus the brain is not getting sufficient information. Secondly, some spinal pathways are also affected in these individuals. Finally, there are some changes in the brain, too, causing them to miscalculate the amount of force needed to manipulate objects.
Thus, researchers say that the next step would be to improve this method, build on it, and create a device that could help in the early diagnosis of diabetic neuropathy. Moreover, this method is pretty simple, and the device based on this technology can be used in any clinical setting and would not require much training or expertise.
By Gurpreet Singh Padda, MD, MBA