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Transcutaneous Application of Gaseous CO2 Improves Diabetic Distal Symmetrical Polyneuropathy in Patients with and
Igor Frangež1,2, Nikolaos Papanas3, Vesna Đermanović Dobrota4
1Department for Surgical Infections, University Medical Center Ljubljana, Ljubljana, Slovenia.
Abstract:
The study explores the effects of non-invasive transcutaneous CO2 therapy on diabetic symmetrical peripheral polyneuropathy (DSPN). Overall, we included 120 patients with diabetes: 40 patients with DSPN (group A) and 40 patients with DSPN and diabetic foot ulceration (DFU) (group B), both receiving 20 sessions of CO2 therapy; 40 DSPN patients not receiving treatment (group C). Outcomes were assessed using the Semmes-Weinstein monofilament test, 128 Hz tuning fork vibration sensation, hallux temperature, wound dimensions, and adverse effects. There was a significant improvement in protective sensation for the CO2-treated groups. Group A exhibited a 53% improvement, while Group B improved by 34% (p = .002). In Groups A, B vibration sensation improvement was 30% and 23%, respectively. Hallux temperature increased more in Group A (5.10 °C) compared with Group B (3.89 °C). Improvement in monofilament sensation was observed in both CO2 treated groups, regardless of ankle-brachial index (ABI), with best results in patients having borderline ABI (67.5% in Group A and 53.1% in Group B). In conclusion, CO2 therapy effectively alleviated DSPN symptoms in patients with/without DFUs, with normal or insufficient circulation, and it was well-tolerated without adverse effects.
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