Background and Introduction

Moderate diabetic neuropathy can lead to significant challenges, including pain, sensory loss, and impaired mobility. This case study details our approach to managing a patient with moderate neuropathy, focusing on symptom relief and functional improvement.

Patient Case Overview

Patient: Male, 62 years old

Diabetes History: Type 2 diabetes for 15 years, poorly controlled with an HbA1c of 8.8%

Symptoms: Persistent burning pain, tingling, and numbness in both feet; occasional shooting pains; difficulty walking more than short distances

Impact on Life: Limited ability to participate in physical activities, significant discomfort when walking or standing, and reduced social engagement due to fear of falling

Initial Presentation and Assessment:

Symptom Severity: 6/10 on the pain scale

Areas of Involvement: Feet and lower legs

Physical Findings: Moderate sensory loss in feet and ankles, diminished reflexes, mild weakness in foot dorsiflexion

Customized Treatment Protocol

For moderate neuropathy, our approach is more intensive, targeting both symptom reduction and functional recovery:

Class IV Laser Therapy

• Objective: Reduce neuropathic pain, enhance nerve regeneration, and improve blood flow

• Procedure: Administered twice weekly for 12 weeks, focusing on deeper nerve tissues. High-energy laser settings were used to penetrate both superficial and deep tissues, promoting cellular repair and reducing inflammation

Pulsed Electromagnetic Field (PEMF) Therapy

• Objective: Support nerve healing, improve circulation, and reduce oxidative stress

• Procedure: Conducted twice weekly, targeting both legs. Therapy settings were adjusted to moderate intensity to enhance the therapeutic effect on nerve cells

Neurolight Therapy

• Objective: Maintain improved blood flow and support ongoing nerve recovery

• Procedure: Daily at-home use of Neurolight for 20 minutes, supplemented by bi-weekly in-clinic sessions to enhance overall outcomes

Physical Rehabilitation and Balance Training

• Objective: Restore mobility, improve balance, and reduce fall risk

• Procedure: Tailored physical therapy focusing on balance exercises, gait training, and lower limb strengthening to rebuild confidence and improve mobility

Nutritional and Glycemic Management

• Objective: Improve glycemic control and reduce systemic inflammation

• Plan: A comprehensive dietary overhaul, emphasizing low glycemic index foods, increased fiber intake, and omega-3 supplementation. The patient received ongoing nutritional coaching to support long-term adherence

Patient Outcomes

• Pain and Sensory Symptoms: Pain reduced from 6/10 to 2/10, with improved sensation in the feet and reduced frequency of shooting pains

• Mobility: The patient regained confidence in walking longer distances and resumed light physical activities, including daily walks

• Quality of Life: Enhanced overall well-being, improved sleep, and increased social participation