How Diabe-Neurosense Screens for Diabetic Peripheral Neuropathy

The Diabe-Neurosense by Biomedionics is a clinical-grade diagnostic device designed to detect diabetic peripheral neuropathy (DPN) at the point of care — in endocrinology clinics, general practice, and even rural health centers across Pakistan. This guide explains how it works, what parameters it measures, and how to integrate it into your clinical workflow.

The Problem: Current DPN Testing is Inadequate

Most Pakistani clinics rely on the 10-gram Semmes-Weinstein monofilament for DPN screening. While inexpensive, the monofilament test has critical limitations:

• Only tests large-fiber pressure sensation — misses early small-fiber neuropathy
• High variability between examiners
• No objective numerical output — purely subjective pass/fail
• Cannot detect neuropathy until significant damage has already occurred

Full NCV (nerve conduction velocity) studies — the gold standard — require a hospital lab, trained neurophysiologist, and cost PKR 3,000–8,000 per test. This is simply not scalable for routine diabetes monitoring in Pakistan.

The Diabe-Neurosense Approach: Multi-Modal Testing

Diabe-Neurosense addresses these limitations by combining multiple nerve function tests in a single, portable device — enabling objective, quantitative DPN screening in under 10 minutes at PKR 90,000 one-time cost.

1. Vibration Perception Threshold (VPT)

The device delivers precisely calibrated vibratory stimuli to the skin surface. The patient indicates when they first perceive the vibration, establishing their Vibration Perception Threshold. Elevated VPT (>25V biothesiometer equivalent) indicates large-fiber neuropathy and is a powerful predictor of foot ulceration risk.

2. Thermal Threshold Testing

Diabe-Neurosense assesses small-fiber nerve function by testing sensitivity to temperature changes. Small-fiber neuropathy (C-fiber and A-delta fiber damage) is the earliest detectable form of DPN — often preceding large-fiber damage by years. Thermal threshold testing catches these patients before monofilament testing would.

3. Nerve Conduction Velocity Assessment

The device incorporates a nerve conduction measurement module that provides an index of peripheral nerve conduction speed — comparable to a basic NCV study. While not a full EMG/NCV lab replacement, it provides clinically actionable NCV data at a fraction of the cost and time.

4. AI-Powered Risk Classification

All measurements are processed through an onboard AI algorithm that classifies each patient's DPN risk as Normal, Mild, Moderate, or Severe — with recommendations for management. The algorithm was trained on clinical datasets incorporating Pakistani diabetic population norms.

Clinical Workflow: Using Diabe-Neurosense

1. Patient preparation: Patient seated, feet bare and at room temperature (18–24°C)
2. Site selection: Standard test sites on dorsal and plantar foot surfaces
3. VPT testing: Apply vibration probe to 5 standard sites; patient indicates perception threshold
4. Thermal testing: Apply thermal probe; patient indicates temperature detection
5. NCV assessment: Automated nerve conduction measurement — no manual calculation required
6. AI report generation: Device generates PDF report with risk classification and management recommendations
7. Total time: 8–12 minutes per patient

Advantages Over Current Methods in Pakistan

• Comprehensive: Tests large AND small fiber function in one session
• Objective: Numerical outputs eliminate examiner variability
• Portable: Clinic-friendly battery operation — no dedicated room required
• Affordable: PKR 90,000 device cost vs. PKR 3,000–8,000 per NCV test
• Pakistan-adapted: AI model trained on South Asian diabetic population data
• Early detection: Detects small-fiber neuropathy years before monofilament testing

Who Should Use Diabe-Neurosense?

• Endocrinologists & diabetologists — for routine annual DPN screening of all diabetic patients
• General physicians — primary care DPN detection before specialist referral
• Physiotherapists — baseline neuromuscular assessment in diabetic rehabilitation
• Research institutions — standardized DPN outcome measurement in clinical trials
• Community health programs — mobile diabetic screening camps