1.1 The case for adopting Neuropad to detect preclinical diabetic peripheral neuropathy is not supported by the evidence.
Why the committee made these recommendations
Neuropad detects abnormal sweating in people with diabetes. But the clinical importance of this is poorly defined. There is insufficient evidence to support the use of Neuropad in people in whom 10 g monofilament testing for diabetic peripheral neuropathy is not possible.
Using Neuropad instead of 10 g monofilament testing would likely increase costs because Neuropad has a lower specificity for detecting diabetic peripheral neuropathy. Cost modelling is uncertain because of the limited clinical-effectiveness evidence. Further research is needed on the benefits and consequences of detecting preclinical diabetic peripheral neuropathy.