Screening for type 2 diabetes and its complications in sub-Saharan Africa:The potential role of Sudoscan

Diabetes has a prevalence rate greater than 10% in some countries of Africa, and a percentage of undetected complications estimated at nearly 80%. The measurement of sweat function has been proposed to evaluate damages of small peripheral nerve fibers that may be injured very early in diabetic patients. SUDOSCAN is a simple, noninvasive, and quantitative method of sweat function, validated by comparison with reference methods for the detection of diabetes and its microvascular complications. The study was conducted in 221 subjects known to be diabetics. The investigation of these patients included the responses to a questionnaire, collection of a capillary blood glucose and HbA1c, and a SUDOSCAN measure. In this population aged 58±11 years, consisting mostly of women (68 %), BMI was 28.2±5.1 kg/m2, HbA1c 7.9±2.3 % and capillary blood glucose 1.6±1.1 g / L. The conductances of the feet of patients with HbA1c or a blood glucose above the median (7.2 % and 1.21 g/L, respectively) were significantly lower than those of patients with HbA1c or blood glucose below the median (70±17 vs. 74±13 μS [P =0.03], and 70±17 vs. 74±13 μS [P =0.04]). All patients found SUDOSCAN examination acceptable and would recommend it to a friend. These very preliminary results indicate that SUDOSCAN could be used in Africa for the detection of diabetic patients and microvascular complications as it has already been demonstrated on other continents.