Objective: To evaluate the effectiveness of low frequency pulsed electro magnetic field (LF-PEMF) in the management of diabetic peripheral neuropathy (DPN) symptoms.
Methods: A comparative observational study of 60 patients, male and female (1:1) aged 6085 years. Enrolment criteria known diabetics, HbA1c 79 and DPN of 15 years. Patients were randomized into 2 treatment groups G1 and G2. The study period was 4 weeks (w) with results assessed at baseline and bi-weekly follow-ups using diabetic neuropathy symptom (DNS) score. G1: 30 patients with an established DPN were treated with PEMF therapy frequency of 10 Hz, thru two emitters of 20 mTesla and 6 mTesla, keeping north polarity was towards the body. A total of 15 sitting of 20 (10+10) min one per day. G2: 30 patients with an established DPN were continued on oral symptomatic treatment options like amitriptyline, duloxetine, gabapentin, pregabalin and tramadol. Patients in both the groups were on Vitamin B 12+ Alpha Liponic Acid which were continued.
Results: In G1 application of LF-PEMF therapy significantly facilitated the regression of the main clinical symptoms of DPN. Patient scores were more differentiated on DNS score. Complete relief in the symptoms of DPN was achieved in four patients at 2 w which sustained at four patients at 4 w. DNS score of 1 was achieved in ten patients. DNS score of 2 was achieved in 18 patients at 2 w which was sustained at 4 w. Overall 32 patients had a relief of main clinical symptoms on the DNS score. In G2 there was a mild regression of the main clinical symptoms of DPN. Complete relief in the symptoms of DPN on DNS score was achieved in 0 patients at 2 w and in one patient at 4 w. DNS score of 1 was achieved in two patients at 2 w which increased to three patients at 4 w. DNS score of 2 was achieved in seven patients at 2 w which was increased to 11 patients at 4 w. Overall 14 patients had a relief of main clinical symptoms on the DNS score.
Conclusion: The present study provides convincing data regarding the effectiveness of LF-PEMF therapy, on patients with DPN symptoms. The usage of oral symptomatic drugs is limited due to the high frequency of adverse events, lack of evidence of long term efficacy and concern about dependence. Considering the benefits and safety, in comparison to oral symptomatic drugs, LF-PEMF can be used as an adjacent in the management of diabetic neuropathy cases. A bigger study is warranted to determine whether DPN can be modulated with LF-PEMF and how it can influence nerve regeneration. Limitations of this study include small sample size, short duration of treatment and non-availability of follow-up data.
Keywords: LF-PEMF low frequency pulsed electro magnetic field, DPN diabetic polyneuropathy, DNS diabetic neuropathy symptom, w weeks.
20 May 2017 - 23 May 2017