The use of low-frequency pulsed electromagnetic field (LF-PEMF) has the potential for managing diabetic peripheral neuropathy better than oral symptomatic drugs, with fewer side effects than those traditional drugs, according to results of a comparative observational study presented at the American Association of Clinical Endocrinologists (AACE) 26th Annual Scientific & Clinical Congress
LF-PEMF “significantly facilitated the regression of the main clinical symptoms of diabetic peripheral neuropathy,” stated lead author Satish Wasoori, MD, Paras Hospitals, Gurgaon, India, speaking here at a poster session on May 5.
Dr. Wasoori and colleagues at his own institution and at G.D. Healthcare & Diabetes Centre, Delhi, India, examined 60 older patients (30 female, age range: 60 to 85 years), all with diabetes, a glycated haemoglobin (HbA1c) of 7 to 9 (high risk), and a history of diabetic peripheral neuropathy for 1 to 5 years. The team randomised subjects into 2 groups in a 1:1 fashion for a 4-week period, and used the diabetic neuropathy symptom (DNS) score to assess patients at baseline and biweekly.
The first group (Group 1) received PEMF therapy at a frequency of 10Hz, through 2 emitters of 20 mTesla and 6 mTesla, with the north polarity oriented toward the body. The team administered a total of 15 sessions, each consisting of two 10-minute sittings per day. The second group (Group 2) received their usual oral symptomatic drugs, including amitriptyline, duloxetine, gabapentin, pregabalin, and tramadol. Both groups were kept on vitamin B12 and alpha-lipoic acid to aid in symptom control.
In Group 1, the investigators found that LF-PEMF produced complete symptom relief in 4 patients at 2 weeks, and that this response was sustained at 4 weeks. The therapy produced a DNS score of 1 in 10 patients at 2 weeks, although the investigators did not note whether this response was sustained at the 4-week mark. A DNS score of 2, however, was achieved in 18 patients at 2 weeks and sustained at 4 weeks, for a total of 32 patients experiencing relief of clinical symptoms as measured by DNS score.
While Group 1 achieved nearly a complete response across the group, only about half of patients in Group 2 experienced significant regression in DNS scores. Compared with LF-PEMF, traditional oral medications produced “a mild regression of the main clinical symptoms of DPN,” Dr. Wasoori noted. Complete symptom relief was achieved in only 1 patient by the 4-week mark, which was not evident at the 2-week mark. Two patients achieved a DNS score of 1 at 2 weeks, which increased to 3 patients at 4 weeks. A DNS score of 2 was observed in 7 patients at 2 weeks, and 11 patients at 4 weeks.
“[This study] provides convincing data regarding the effectiveness of LF-PEMF therapy,” the investigators concluded, noting that the use of oral medications “is limited due to the high frequency of adverse events, lack of evidence of long-term efficacy, and concern about dependence.” LF-PEMF therapy, they noted, “can be used as an adjacent in the management of diabetic neuropathy cases.”
They added that larger, long-term studies with more follow-up data are needed to determine whether LF-PEMF can modulate diabetic peripheral neuropathy, and how it can influence nerve regeneration.
[Presentation title: Management of Diabetic Peripheral Neuropathy (DPN) Using Low Frequency Pulsed Electro Magnetic Field (LF-PEMF). Abstract 272]