Comparative Efficacy Of Low-Level Laser Therapy And Transcutaneous Electrical Nerve Stimulation In The Management Of Diabetic Peripheral Neuropathy: A Randomized Controlled Trial

Introduction: Diabetic peripheral neuropathy is a common and debilitating complication of diabetes, characterized by distal sensory loss, pain, and functional impairment. Conventional pharmacologic treatments often provide incomplete symptom relief and are associated with adverse effects, highlighting the need for effective adjunctive therapies. Low-level laser therapy and transcutaneous electrical nerve stimulation (TENS) have been proposed as non-pharmacologic options for diabetic peripheral neuropathy management. This study aimed to compare the efficacy of laser therapy and nerve stimulation, as adjuncts to standard pharmacologic therapy, versus pharmacologic therapy alone in improving clinical symptoms and electrophysiological parameters in patients with diabetic peripheral neuropathy. Materials and Methods: In this single-center, randomized controlled trial, 60 adult patients with confirmed DPN unresponsive to ≥3 months of pharmacologic therapy were randomized into three groups: control (standard therapy, laser therapy and nerve stimulation (n=20 each. Interventions were delivered over 6 weeks, with 12 sessions for each therapy. Clinical assessments included sensory disturbance, pain and temperature sensation, and monofilament testing. Electrophysiological evaluations included nerve conduction studies (peroneal and tibial nerves) and H-reflex assessment. Ankle-brachial index was also measured. Statistical analysis included ANOVA, paired t-tests, and non-parametric equivalents with significance set at p