A smartphone-based tool for screening diabetic neuropathies: A mHealth and 3D printing approach

Diabetic neuropathy, a nerve damage associated with diabetes mellitus, can lead to severe disabilities, morbidity, and mortality, if not diagnosed in a timely manner. Diabetic neuropathies represent a huge economic burden and are a growing problem in sub-Saharan Africa, where they affect up to 61% of the diabetic population. Therefore, the United Nations (UN) has included the reduction of the diabetes-related mortality, as a priority in the Sustainable Development Agenda. A review of the current existing solutions for diabetic patients highlighted the fact that many are focused on lifestyle management and glycemia monitoring, while less are available for diabetic neuropathies screening, in particular in the digital health field. Beyond cutting-edge screening methods, which are time-consuming and equipment-heavy, traditional ones are effective, but they require specialised knowledge, which often lacks in low-resource settings. These settings, specifically those in low-income countries, are challenged by the lack of expertise, funds, spare parts, and consumables and harsh environmental conditions, which hinder the safe use of medical devices. This paper proposes a smart-tool for the screening of diabetic neuropathies based on the effective combination of three already established methods, through 3D-printed accessories and a smartphone app, aiming at contributing towards the UN’s Sustainable Development Goal 3, as well as the fourth industrial revolution in healthcare. Moreover, an on-field evaluation for this smart-tool is ongoing. So far, we recruited 11 normosubjects as a pilot study. The results demonstrate that it could be a viable solution to improve the standard of care of diabetic patients, specifically in the field of diabetic neuropathy screening, globally, as well as locally in low-resource settings.