The Semmes–Weinstein Monofilament as a Potential Predictor of Foot Ulceration in Patients With Noninsulin-Dependent Diabetes

• Published in: The American journal of the medical sciences 1995-02, Vol.309 (2), p.76-82
• Main Authors: Olmos, Pablo R., Cataland, Samuel, O’Dorisio, Thomas M., Casey, Cecilia A., Smead, William L., Simon, Sheldon R.
• Format: Article
• Language: English
• Subjects: Aged; Associated diseases and complications; Biological and medical sciences; Diabetes Mellitus, Type 2 - complications; Diabetes. Impaired glucose tolerance; Diabetic Foot - diagnosis; Diabetic Foot - etiology; Diabetic Foot - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Foot; Humans; Male; Medical sciences; Middle Aged; Neuropathy; Noninsulin-dependent diab etes; Peroneal Nerve - pathology; Predictive Value of Tests; Risk Factors; Sensory Thresholds; Skin - physiopathology; Ulcer
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1097/00000441-199502000-00004

The objective was to evaluate the Semmes–Weinstein monofilament as a potential predictor of foot ulceration. A case-control study was carried out in a teaching hospital clinic specializing in diabetes and hyperlipidemic disorders. Two groups of patients with noninsulin-dependent diabetes mellitus were studied: 168 with no history of foot lesions (No-Ulcer group, aged 58.1±9.7 years, duration 11.5±7.8 years) and 14 who had at least one foot ulceration during the last year (foot ulcer group, aged 60.8±7.8 years’, duration 17.1±10.5 years). The authors defined and measured a “monofilament index” using a size 5.07 Semmes–Weinstein monofilament on three locations on each foot and then measured peroneal nerve current perception thresholds using the Neurometer® at three frequencies: 5Hz, 250Hz, and 2,000Hz. The monofilament index score was lower in patients in the foot ulcer group than in patients in the No-Ulcer group (1.71±2.36 vs 5.21±1.81, P