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Lower Extremity Amputation Prevention

Lower Extremity Amputation Prevention (LEAP) is a comprehensive program that can dramatically reduce lower extremity amputations in individuals with diabetes mellitus, Hansen's disease, or any condition that results in loss of protective sensation in the feet.

LEAP recommends that individuals with diabetes be screened for loss of protective sensation on an annual basis. LEAP recommends that patients who believe they have discovered a loss of sensation should see their health care provider as soon as possible.

The LEAP Program consists of five relatively simple activities:

  • Annual foot screening
  • Patient education
  • Daily self inspection of the foot
  • Appropriate footwear selection
  • Management of simple foot problems

The foundation of this prevention program is an easy to use, screening implement (a 5.07 monofilament), which is calibrated to apply 10 grams of force when pressed against the foot. The LEAP foot screening will identify patients with a foot at risk of developing problems.

Evaluation of a Self-Administered Sensory Testing Tool to Identify Patients at Risk of Diabetes-Related Foot Problems, a LEAP study published in the January 1998 issue of Diabetes Care, reported that 87 percent of the patients who participated in the study obtained the correct results as documented by their primary care provider.

LEAP was developed at the HRSA National Hansen's Disease Program in 1992.

Free LEAP Monofilaments

Single LEAP Test Kit for individuals with diabetes

LEAP Test Kit with 10 monofilaments (maximum order: 5 kits, each with one 10-pack) for health professionals to distribute to patients with diabetes and show them how to use them.
We have limited funding and supplies. Please do not make multiple requests from the same organization.

Resources for larger quantities of monofilaments to purchase (National Diabetes Education Program)


Lower Extremity Amputation Prevention and Treatment of the Neuropathic Foot (Online Course)

Comprehensive Management of the Neuropathic Foot Seminar
(printer-friendly form)

Performing foot exams to prevent lower extremity amputations in patients with diabetes (12-minute video, requires RealPlayer), for clinicians.

Foot Assessment of the Adult Diabetic Patient (5-minute video, requires RealPlayer), for patients.

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