AUTHOR=Sakai Mayu , Kato Takehiro , Ishihara Takuma , Takao Ken , Hirose Tokuyuki , Kubota Sodai , Kubota-Okamoto Saki , Imaizumi Toshinori , Takahashi Yoshihiro , Mizuno Masami , Hirota Takuo , Horikawa Yukio , Sakaguchi Hirokazu , Tsunekawa Shin , Yabe Daisuke 

TITLE=Predicting diabetic retinopathy stages using a simple nerve conduction measuring device, DPNCheck®: a retrospective observational study

JOURNAL=Frontiers in Clinical Diabetes and Healthcare

VOLUME=Volume 6 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2025.1590407

DOI=10.3389/fcdhc.2025.1590407

ISSN=2673-6616

ABSTRACT=Aims/introductionDiabetic retinopathy (DR) often remains asymptomatic until it reaches advanced stages, when delayed treatment can lead to irreversible visual impairment. To promote timely ophthalmology visits, this study investigated the utility of a simple nerve conduction device, DPNCheck®, as a predictor of DR severity. Previous research has established a relationship between diabetic neuropathy (assessed by conventional nerve conduction studies) and DR progression; however, the specialized equipment and expertise required limit its practicality. In contrast, DPNCheck® is a simpler alternative that quantifies neuropathy severity through the severity of the estimated modified Baba classification (eMBC).Materials and methodsUsing electronic medical records (EHRs), we identified individuals with diabetes who underwent DPNCheck® and subsequent ophthalmologic assessment for DR. Based on age and sural nerve conduction data, an eMBC was calculated. Meanwhile, DR severity was scored using a modified Davis classification, defining four stages (DR severity scores 0–3).ResultsOf 181 individuals extracted from our hospital’s EHRs, 146 were eligible for analysis. Ordinal logistic regression showed that eMBC was significantly associated with DR stage, independent of diabetes duration and HbA1c. Receiver operating characteristic (ROC) curve analyses yielded eMBC cut-off values of 1.11, 1.51, and 1.51 to predict DR severity scores of ≥1, ≥2, and ≥3, respectively. Sensitivities ranged from 0.67 to 0.78, and specificities from 0.66 to 0.81. An eMBC of 1.51 or above was strongly associated with preproliferative or proliferative DR, indicating a need for urgent ophthalmology referral.ConclusionsDPNCheck®, a simple nerve conduction measurement device, may help predict DR severity and facilitate timely ophthalmologic care.