Comparison of sensory testing on different toe surfaces: implications for neuropathy screening.

Successful screening for neuropathy in patients with diabetes is available using the 10 g Semmes-Weinstein monofilament (Mid-Delta Health Systems, Inc., Belzoni, MS) (touch/pressure sensation) and the Neurothesiometer (Horwell Scientific, London, UK; vibration perception threshold). In healthy volunteers and patients with a broad range of diabetic sensorimotor neuropathy, we show that the predictive value of either test for diabetic sensorimotor neuropathy depends on the toe surface tested. These results establish the importance of standardized screening methods for diabetic sensorimotor neuropathy in the clinic and in clinical research trials.