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 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