Endocrine Abstracts

JOINT101

Background: Painful diabetic peripheral neuropathy (DPN) is a debilitating complication of diabetes with limited therapeutic options. Frequency Rhythmic Electrical Modulation System (FREMS), a non-invasive electrotherapy, has shown potential in managing the symptoms. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on FREMS for symptomatic DPN.

Methods: Databases, including PubMed, Scopus, and Embase, were searched until October 2024. Studies involving adults with DPN comparing FREMS with placebo were included. Data on Visual Analog Scale (VAS) scores and nerve conduction were extracted. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random-effects models. Risk of bias was assessed using RoB 2. Heterogeneity was quantified via I² statistics, with sensitivity analyses and publication bias evaluation.

Results: Five RCTs (302 participants) were included. FREMS significantly reduced daytime VAS pain scores post-treatment (SMD -0. 56, 95% CI -0. 82 to -0. 29, I²= 4%) and at follow-up (SMD -0. 47, 95% CI -0. 73 to -0. 21, I² = 0%). Night-time VAS pain scores also improved post-treatment (SMD -0. 54, 95% CI -0. 80 to -0. 27, I² = 44%) and at follow-up (SMD -0. 38, 95% CI -0. 65 to -0. 12, I² = 1%). FREMS improved motor nerve conduction but showed no effect on sensory conduction or microvascular blood flow.

Conclusion: FREMS is effective in reducing DPN pain with sustained benefits and a favorable safety profile. Future research should focus on standardizing treatment protocols and exploring long-term outcomes to integrate FREMS into clinical practice effectively.

Keywords: Diabetic peripheral neuropathy; Frequency Rhythmic Electrical Modulation System (FREMS); pain management; nerve conduction; microvascular function; non-invasive treatment.