London - Diabetes patients could soon be able to check for nerve damage using a home device which works by detecting sweat.
The new stick-on pad changes colour from blue to pink when all is well, but does not change if there are problems with the nerves.
Diabetic neuropathy, or nerve damage, is a common complication of uncontrolled diabetes.
Typically, it affects the extremities – when it is known as peripheral diabetic neuropathy – and is estimated to affect up to 50 percent of all patients with diabetes.
It occurs when high blood sugar levels damage nerve fibres.
Symptoms can include pain and numbness, but the main danger is patients may not feel minor injuries, which can become infected or ulcerated.
These wounds can be difficult to heal because diabetes also reduces blood flow to the feet.
Infections can spread and cause tissue death or gangrene; it’s estimated that every week, 100 people lose a foot or limb through diabetes.
Detecting the condition at an early stage would mean that preventive action, such as checking the feet daily for signs of injury, could be taken.
Current checks include a “nerve condition” test, or electromyography, where electrodes are inserted into the muscles to assess nerve function. However, this has to be carried out at a clinic by a professional.
The new test – which is designed specifically for the feet – is much simpler and can be done at home.
It works on the basis that damage of the nerves leads not only to a loss of sensation, but also a malfunctioning sweat system and, in turn, unusually dry skin on the feet. The adhesive pad contains the blue salt anhydrous cobalt II chloride, which reacts and changes to pink when exposed to water.
The patient just has to remove his or her socks to allow the foot to adjust to room temperature before applying the pad, called Neuropad, which is kept in place for about 10 minutes.
If there is no sweat, there will be minimal or no colour change – this suggests early diabetic neuropathy.
A new study by researchers at Oxford University and other centres looked at the results of about 3 000 people and found it to be 86 percent accurate. The test is already available in the UK through some diabetes specialists.
Stella Vig, a consultant vascular and general surgeon and chairwoman of the London Diabetic Foot Network, says: “This is an exciting innovation. In association with a yearly foot screen and referral to the podiatry services, this will reduce the risk of amputations.
“Up to 50 percent of amputations may be preventable – no patient should ignore their feet.”
Meanwhile, a hi-tech sachet that gradually releases insulin into the body could mean an end to daily jabs for millions of people with diabetes.
Implanted under the skin on the patient’s side or back, the sachet – roughly the size and shape of a tomato sauce packet from a take-away restaurant – is packed with embryonic stem cells, which have been engineered in a laboratory to turn into insulin-producing cells.
Diabetes occurs when the pancreas stops producing insulin, its output drops sharply or the body becomes resistant to insulin. Insulin helps the muscles absorb sugar from the blood to burn as a source of fuel.
Scientists have been looking at whether stem cells could be used to produce insulin instead of the pancreas.
Although progress has been made in turning stem cells into mini-insulin factories, a major problem has been how to protect them against attack by the immune system, which considers them “foreign” and tries to destroy them.
But the new sachet, developed by US company ViaCyte, contains a membrane with pores tiny enough to prevent immune system antibodies getting in, but large enough to allow insulin molecules – which are considerably smaller – to get out.
The stem cells are packed inside the sachet, which is made from a type of plastic.
Over two to three months inside the body, the stem cells grow into insulin-producing cells which mimic those normally found in a healthy pancreas.
It takes this long because the new cells need a rich blood supply to grow, and it can take several months for new blood vessels to grow around the implant and provide the nutrient that the cells need.
Once the new cells start producing insulin, it can seep through the hundreds of tiny pores into the bloodstream.
The treatment has been tried only on mice so far.
More than 1 000 of the rodents have received a miniature version of the implant, and results show the sachet can control blood sugar levels as effectively as regular insulin jabs.
Human trials are expected to start within the next year or two. It’s hoped that the sachet will last for life. – Daily Mail