Neuropathy and Vascular Disease

There are numerous medical conditions that can lead to neuropathy and vascular disease. However, in the U.S. population, the leading cause is diabetes. According to the CDC, diabetes is now one of the most prevalent health care problems of the 21st century and is predicted to reach pandemic levels by 2030. It is also estimated that more than 23 percent of our population with diabetes are undiagnosed and nearly 34 percent of all U.S. adults are prediabetic.

Peripheral arterial disease and neuropathies are the most common chronic complications associated with diabetes mellitus. Diabetic peripheral neuropathy (DPN) is a leading cause for disability due to foot ulceration and amputation, gait disturbance, and fall-related injury. Approximately 20 to 30% of patients with DPN suffer from pain and patients with prediabetes may also develop neuropathies that are similar to diabetic neuropathies.

Diagnosis and Treatment

According to the American Diabetes Association (ADA), early recognition and appropriate management of neuropathies are of the utmost importance. The reasoning for this is that 50 percent of diabetic peripheral neuropathies may be asymptomatic and with proper diagnosis and preventative foot care, the risk of injuries decreases dramatically.

The ADA released a statement paper in January 2017 that stated “Due to a lack of treatments that target the underlying nerve damage, prevention is the key component of diabetes care. Screening for symptoms and signs of diabetic neuropathy is also critical in clinical practice, as it may detect the earliest stages of neuropathy, enabling early intervention.”

It has also been shown that nearly 50 percent of all diabetics with foot ulcers also present with peripheral artery disease (PAD) that is generally caused by accelerated atherosclerosis. PAD is also an important factor in impaired wound healing. The majority of foot ulcers are caused by a combination of neuropathy and ischemia and may go unnoticed due to lack of pain.


Our TM-Flow is the only available device for the early detection and monitoring of neuropathic and vascular complications resulting from chronic diseases, such as diabetes. As stated above, early detection and ongoing routine monitoring are essential when treating patients that have diabetes and even pre-diabetes. The TM-Flow offers both autonomic nervous system and vascular function assessments that include:

  • Sudomotor Function Markers
  • Heart Rate Variability (HRV)
  • Cardiac Autonomic Reflex Tests, Valsalva Ratio, E/I Ratio and K30/15 Ratio
  • Peripheral circulation from the Photoplethysmography (PTG) analysis
  • Arterial stiffness and Ankle Brachial Indices (ABI) from the Volume Plethysmography analysis

This device offers you a non-invasive, pain-free, rapid screening tool for all of your patients and is covered by most insurance plans. Our company, Bird Dog Pharma, provides you with a turnkey and seamless addition to your practice with no capital investment required and offers an additional revenue stream. We can provide a skilled technician, we global bill all claims, in-network, so no additional work for your staff and we professionally manage any patient billing concerns. This service allows you to provide patient-specific care and closely monitor your patient’s response to treatment through easy access to services.