Dosimetric parameters and clinical outcomes of photobiomodulation in diabetic neuropathy: a concise review
摘要
Diabetes mellitus (DM) is a multifactorial metabolic disorder characterized by chronic hyperglycemia, insulin resistance, and systemic inflammation. Diabetic neuropathy (DN) is a prevalent and debilitating complication of type 2 diabetes mellitus (T2D), associated with sensory impairment, persistent pain, and increased risk of lower limb amputations. Photobiomodulation (PBM) has been investigated as an adjunctive treatment due to its effects on cellular repair mechanisms, pain modulation, and wound healing.This review aims to synthesize evidence from clinical and preclinical studies published between 2015 and 2025, focusing on dosimetric parameters used in PBM for DN and their association with clinical outcomes.The search was conducted in the LILACS, SciELO, EMBASE, MEDLINE, PubMed e Cochrane Library, covering publications from 2015 to 2025. A total of 23 studies met the inclusion criteria. This review provides comprehensive evidence supporting PBM as a promising, safe and effective adjunctive therapy for diabetic neuropathy. The most consistent therapeutic effects were observed with wavelengths ((630–670 nm/808–904 nm), fluences of 3–10 J/cm², output power between 45 and 100 mW, and treatment protocols comprising at least 12 sessions. Despite the favorable therapeutic outcomes, the absence of standardized dosimetry among the studies remains a major challenge. Therefore, further research is needed to define optimized and reproducible therapeutic protocols.
Graphical abstract