1.1 The case for adopting Neuropad to detect preclinical diabetic peripheral neuropathy is not supported by the evidence. Neuropad detects sub-normal sweating in patients with diabetes but the clinical importance of this in current NHS care pathways is poorly defined. There is insufficient evidence to support the use of Neuropad in patients in whom 10 g monofilament testing for diabetic peripheral neuropathy is not possible.
1.2 Cost modelling is uncertain because of the limited clinical-effectiveness evidence. Using Neuropad instead of 10 g monofilament testing would likely increase costs because Neuropad has a lower specificity for detecting diabetic peripheral neuropathy. Further research is needed on the benefits and consequences of detecting preclinical diabetic peripheral neuropathy.