Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Diabetes Health Center

Font Size

Feet Can Last a Lifetime

IV. Sensory Foot Exam

The sensory testing device used to complete a foot exam is a 10-gram (5.07 Semmes-Weinstein) nylon filament mounted on a holder that has been standardized to deliver a 10-gram force when properly applied. Research has shown that a person who can feel the 10-gram filament in the selected sites is at reduced risk for developing ulcers.

  • The sensory exam should be done in a quiet and relaxed setting. The patient must not watch while the examiner applies the filament.
  • Test the monofilament on the patient's hand so he/she knows what to anticipate.
  • The five sites to be tested are indicated on the screening form.
  • Apply the monofilament perpendicular to the skin's surface (see diagram A below).
  • Apply sufficient force to cause the filament to bend or buckle (see diagram B below).

  • The total duration of the approach, skin contact, and departure of the filament should be approximately 1-1/2 seconds.
  • Apply the filament along the perimeter and not on an ulcer site, callus, scar or necrotic tissue. Do not allow the filament to slide across the skin or make repetitive contact at the test site.
  • Press the filament to the skin such that it buckles at one of two times as you say "time one" or "time two." Have patients identify at which time they were touched. Randomize the sequence of applying the filament throughout the examination.

V. Risk Categorization

Based on the foot exam, determine the patient's risk category. A definition of "low risk" or "high risk" for recurrent ulceration and ultimately, amputation, is provided in the chart below along with minimum suggested management guidelines. Individuals who are identified as "high risk" may require a more comprehensive evaluation.

Risk Category Defined

Management Guidelines

Low Risk Patients
None of the five high risk characteristics below.

Conduct an annual foot screening exam.
Assess/recommend appropriate footwear.
Provide patient education for preventive self-care.

High Risk Patients
One or more of the following:
Loss of protective sensation
Absent pedal pulses
Severe foot deformity
History of foot ulcer
Prior amputation

Conduct foot assessment every 3 months.
Demonstrate preventive self-care of the feet.
Refer to specialists and a diabetes educator as indicated.(Always refer to a specialist if Charcot joints are suspected.)
Assess/prescribe appropriate footwear.
Certify Medicare patients for therapeutic shoe benefits.
Place "High Risk Feet" sticker on medical record.

Management Guidelines for Active Ulcer or Foot Infection

  • Never let patients with an open plantar ulcer walk out in their own shoes. Weight relief must be provided.
  • Assess/prescribe therapeutic footwear to help modify weight bearing and protect the feet.
  • Conduct frequent wound assessment and provide care as indicated.
  • Demonstrate preventive self-care of the feet.
  • Provide patient education on wound care.
  • Refer to specialists and a diabetes educator as indicated.
  • Certify Medicare patients for therapeutic footwear benefits (after ulcer heals).
  • Place "High Risk Feet" sticker on medical record.

Today on WebMD

Diabetic tools
Symptoms, diagnosis, treatment, and more.
woman flexing muscles
10 strength training exercises.
Blood sugar test
12 practical tips.
Tom Hanks
Stars living with type 1 or type 2.
kenneth fujioka, md
Can Vinegar Treat Diabetes
Middle aged person
jennie brand miller

Prediabetes How to Prevent Type 2 Diabetes
type 2 diabetes
food fitness planner