Diabetes is the major cause of nontraumatic lower-limb amputation and is commonly preceded by foot ulceration and infection. The underlying etiology of this ulceration is usually a loss of protective sensation due to peripheral neuropathy, for which there is at present no completely satisfactory strategy for prevention. Current teaching promotes early detection of neuropathy so that secondary prevention measures, such as intensive foot-care education and treatment, can be implemented for individuals at risk. In an effort to standardize and simplify the detection of insensate foot, the 5.07/10-gm monofilament is recommended by the International Diabetes Federation and the World Health Organization as a device that can be used by health professionals at every level of care.

It is calibrated to buckle when a force of 10 gm is exerted, and if a patient cannot feel the pressure, the foot is considered to be insensate. While conceptually simple, there is no universally accepted guideline on how the monofilament is to be used or the results interpreted. Among the many methods described in the literature, Mueller tested three metatarsal heads and toes, the medial and lateral midfoot, and the heel. Holewski et al, used the dorsal surface of the foot between the first and second toes and the base of the third and fifth metatarsals. Olmos et al. tested three sites, the Hansens's Disease Center recommends testing 10 sites, and Kumar et al, tested only one site. Therefore, one of the aims of this study is to evaluate the impact of using different locations and combinations of sites for testing.

Birke and Rolfsen concluded that self-administered sensory testing using the monofilament is useful for providing patients an opportunity to share in the responsibility for preventing diabetes foot problem