Demystifying Diabetic Neuropathy: The Secret Is in Your Sweat

Demystifying Diabetic Neuropathy: The Secret Is in Your Sweat

Every day, our experienced podiatrists, Dan Preece, DPM, and Darren Groberg, DPM, part of the Utah Musculoskeletal Specialists in Salt Lake City, see the damage caused by diabetic neuropathy. Sustained high levels of blood sugar wreak havoc on the nerves throughout your body, but especially in your feet.

The classic symptoms of neuropathy are tingling and numbness, but how do you know for sure if your diabetes has affected the nerves in your feet? 

While your symptoms give us a clue, they aren’t enough to establish a firm diagnosis. For that, we rely on two types of advanced technology — one measures your ability to detect pressure, and the other identifies small nerve damage by testing your sweat glands.

Pressure specified sensory device (PSSD)

One way we test your nerves for entrapment or damage is with the pressure specified sensory device. The PSSD test is easy and painless and is often the first test we run if you experience symptoms of pain, tingling, or numbness in your legs or feet.

While you recline comfortably in a chair, we touch the affected area — typically the bottom of your feet — with a small, handheld device that has two small metal prongs. We can adjust the distance between the two prongs to accommodate different body parts and different patients.

When both prongs are touching your skin, we ask you to let us know if you feel both prongs, only one, or neither. That’s it! There’s no electrical shock and no other uncomfortable sensation.

This gives us vital information about the general function of your nerves, but it doesn’t stop there. The device measures and records your nerves’ threshold levels and innervation densities. This generates a computerized analysis of your nerve health. 

Using PSSD, Drs. Groberg and Preece can monitor your nerves and determine whether treatment is helping or if your condition is progressing.


Diabetes can cause irreversible damage to your nerves, but if we catch it early, we may be able to slow or stop the progression of the destruction. In some cases, the nerves may even regenerate. But early detection is critical. For many years, doctors missed early signs because the damage began in small nerve fibers, which were nearly impossible to monitor — until now.

SUDOSCAN, developed in 2005 by San Diego-based Impeto Medical, offers an innovative way to detect small nerve damage. SUDOSCAN is 100% painless and noninvasive and takes only 2-3 minutes to do. You place your feet (or hands) on a plate that emits very low voltage to stimulate or stress your sweat glands. The device measures the electrochemical reaction between the chloride ions in your sweat and the device’s electrodes to determine nerve function.

What do sweat glands have to do with your nerves? To explain that, you need to understand the role of your autonomic nervous system, which controls all of your body’s involuntary functions, such as breathing, digestion, bladder, and sexual organs, etc. 

It also controls your body temperature, and when you get too hot, your autonomic nervous system uses sweat as a coolant. By detecting a problem in your sweat production, we can diagnose a problem with your entire autonomic nervous system. 

Before SUDOSCAN, physicians had to conduct invasive procedures, such as skin biopsies and nerve conduction tests, to reach a diagnosis. Those are time-consuming and laborious procedures that often deliver inconclusive results. But SUDOSCAN allows us to measure electrical conductance of sweat glands with instant results and less than 5% error.

Not only does SUDOSCAN allow us to diagnose small nerve damage, but now we can accurately monitor nerve health progression and even nerve recovery. That’s right, the small nerves that control the sweat glands are capable of recovering.

If you have diabetes, it’s critical that you control your blood sugar and keep regular appointments with your primary care physician. But if you experience tingling or numbness in your feet, come see us as soon as possible and take advantage of the latest technology to catch — and maybe reverse — diabetic neuropathy.

To schedule an appointment, book online or call us today. 

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