Evaluating Sudomotor Function: Aging, Diabetes, and the Sudomotor Autonomic Neuropathy Index
Annie TL Young, Slav Danev, Jonathan RT Lakey
Assessing sudomotor function is essential for diagnosing and monitoring autonomic disorders,
especially in cases of diabetes and small fiber neuropathies. Traditional methods are effective but often
complicated and less accessible. Recent innovations, particularly the VitalScan-SudoCheck, provide
a non-invasive and rapid alternative for evaluating sudomotor function through techniques such as
Quantitative Sudomotor Axon Reflex Test (QSART) and Sympathetic Skin Response (SSR).
This study investigates the impact of aging on the risk of developing autonomic neuropathy within a
large cohort (n=143,900) using the Sudomotor Autonomic Neuropathy Index (SANI). As individuals
age from 20 to 90 years, their SANI scores increase, reflecting a higher risk of autonomic neuropathy.
Additionally, the study evaluates the effectiveness of the SANI score in detecting diabetic neuropathy
compared to clinical diagnoses made by healthcare professionals for patients with type 2 diabetes
mellitus (T2DM). The findings reveal that T2DM patients (n=2,560) have higher SANI scores than the
elderly cohort aged 80 to 90.
The SANI, developed by SudoCheck, facilitates comprehensive monitoring of autonomic health,
particularly among older adults. Despite these encouraging findings, further research is necessary
to standardize sudomotor function tests and enhance their clinical utility. By addressing the barriers
to the adoption of sudomotor assessments, this study highlights the importance of timely diagnosis in
improving patient outcomes and managing the economic impact of diabetes-related complications.
