Sudoscan reclassifies cardiovascular risk in patients with type 2 diabetes mellitus according to the ESC 2023.

Objectives: The objective of this study is to determine if the detection of DAN through Sudoscan can reclassify cardiovascular risk in patients with T2DM according to the European Society of Cardiology guidelines 2023 (ESC 2023) compared to other risk scales.

Methods: A retrospective cross-sectional analytical study was conducted on 161 patients with T2DM who had undergone Sudoscan in a Northern Mexico Hospital between December 2022 and July 2023. We compared the cardiovascular risk with SCORE-2, SMART, ADVANCE, ASCVD plus, and Globo Risk scales.

Results: Estimated cardiovascular risk according to the ESC 2023 without consideration of DAN was low for 91 (57%), moderate for 53 (33%), high for 11 (7%) and very high for 22 (3%) of patients. While inclusion of DAN resulted in low risk in 81 (51%), moderate in 46 (28%9, high in 9(5%) and very high risk for 25 ((16%),  = 0.004). The majority of patients were classified as low or moderate risk using other scales such as ASCVD plus, SCORE-2, Globo Risk, ADVANCE, and SMART.

Conclusions: Sudoscan enhances cardiovascular risk assessment in T2DM by accurately diagnosing microvascular complications, ensuring comprehensive patient evaluation.