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

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 we...

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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
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description 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
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The peroneal nerve current perception threshold was higher (P&lt;0.005) in patients in the foot ulcer group than in patients in the No-Ulcer group for all frequencies (605.8±414.6 vs 181.5±272.3 for 5Hz; 743.2±361.7 vs 251.6±283.7 for 250Hz; 859.4±220.2 vs 423.3±252.6 for 2,000Hz). For the Neurometer®, the best combination of sensitivity rate (92.9%) and false-positive rate (26.2%) was attained at a frequency of 2,000Hz, with a cutoff point at 450 (4.5mA). 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Impaired glucose tolerance</topic><topic>Diabetic Foot - diagnosis</topic><topic>Diabetic Foot - etiology</topic><topic>Diabetic Foot - physiopathology</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Foot</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neuropathy</topic><topic>Noninsulin-dependent diab etes</topic><topic>Peroneal Nerve - pathology</topic><topic>Predictive Value of Tests</topic><topic>Risk Factors</topic><topic>Sensory Thresholds</topic><topic>Skin - physiopathology</topic><topic>Ulcer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olmos, Pablo R.</creatorcontrib><creatorcontrib>Cataland, Samuel</creatorcontrib><creatorcontrib>O’Dorisio, Thomas M.</creatorcontrib><creatorcontrib>Casey, Cecilia A.</creatorcontrib><creatorcontrib>Smead, William L.</creatorcontrib><creatorcontrib>Simon, Sheldon R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of the medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olmos, Pablo R.</au><au>Cataland, Samuel</au><au>O’Dorisio, Thomas M.</au><au>Casey, Cecilia A.</au><au>Smead, William L.</au><au>Simon, Sheldon R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Semmes–Weinstein Monofilament as a Potential Predictor of Foot Ulceration in Patients With Noninsulin-Dependent Diabetes</atitle><jtitle>The American journal of the medical sciences</jtitle><addtitle>Am J Med Sci</addtitle><date>1995-02-01</date><risdate>1995</risdate><volume>309</volume><issue>2</issue><spage>76</spage><epage>82</epage><pages>76-82</pages><issn>0002-9629</issn><eissn>1538-2990</eissn><coden>AJMSA9</coden><abstract>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&lt;0.001). A cutoff point at an index of 5 out of 6 yielded a sensitivity rate of 85.71% and a false-positive rate of 16.07%. The peroneal nerve current perception threshold was higher (P&lt;0.005) in patients in the foot ulcer group than in patients in the No-Ulcer group for all frequencies (605.8±414.6 vs 181.5±272.3 for 5Hz; 743.2±361.7 vs 251.6±283.7 for 250Hz; 859.4±220.2 vs 423.3±252.6 for 2,000Hz). For the Neurometer®, the best combination of sensitivity rate (92.9%) and false-positive rate (26.2%) was attained at a frequency of 2,000Hz, with a cutoff point at 450 (4.5mA). The authors conclude that the monofilament index using the 5.07 Semmes–Weinstein monofilament is inexpensive and a promising potential predictor for foot ulceration in patients with noninsulin-dependent diabetes mellitus.</abstract><cop>Hagerstown, MD</cop><pub>Elsevier Inc</pub><pmid>7847445</pmid><doi>10.1097/00000441-199502000-00004</doi><tpages>7</tpages></addata></record>
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source ScienceDirect Journals
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
title The Semmes–Weinstein Monofilament as a Potential Predictor of Foot Ulceration in Patients With Noninsulin-Dependent Diabetes
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