BACKGROUND: Distal peripheral neuropathy (DPN) is a prevalent issue among patients with type 2 diabetes mellitus. Despite the widespread use of low-level laser therapy (LLLT) and limited use of Tecar therapy in physiotherapy for diabetics, the synergistic effect of these two interventions in a long-term follow-up has not yet been determined. OBJECTIVES: This study aimed to compare the effects of Tecar therapy and LLLT separately and simultaneously over a 3-month follow-up period on clinical symptoms and health-related quality of life in individuals with type 2 diabetes and DPN. METHODS: In this double-blind, randomized clinical trial, forty-five individuals with type 2 diabetes (30 women and 15 men) with DPN were randomly assigned to three groups of 15 people: Tecar-on plus laser-sham, Tecar-on plus laser-on, and laser-on plus Tecar-sham. The patients received ten treatment sessions and were followed up for 3-months after the last session. Health-related quality of life was assessed using the WHOQOL-BREF Questionnaire, while clinical symptoms, including pain (measured with a Visual Analog Scale), functional balance (evaluated with the timed-up and go test), and neuropathy symptoms (assessed with the Michigan Questionnaire) were also recorded. RESULTS: Inter-group comparison after ten sessions revealed that the Tecar-on plus laser-sham and Tecar-on plus laser-on groups exhibited significant improvement in neuropathy symptoms compared to the laser-on plus Tecar-sham group. Even after the 3- month follow-up, these two groups showed lasting improvement in all variables compared to the laser-on plus Tecar-sham group (p < 0.05). The Tecar-on plus laser-on group demonstrated a more enduring significant effect on pain scores (p = 0.035) compared to the Tecar-on plus laser-sham group after the 3-month follow-up. In intra-group comparison, all three groups showed significant improvement in clinical symptoms and health-related quality of life after ten treatment sessions compared to before treatment (p < 0.05). Moreover, after the 3-month follow-up, both the Tecar-on plus laser-sham group and the Tecar-on plus laser-on group demonstrated a more lasting significant effect in all variables compared to before treatment (p < 0.05). For the laser-on plus Tecar-sham group, a more durable improvement in health-related quality of life (p = 0.000) and neuropathy symptoms (p = 0.011) was reported after the 3-month follow-up compared to before treatment. CONCLUSIONS: Although all three groups exhibited significant improvement in clinical symptoms and health-related quality of life in individuals with type 2 diabetes and DPN after ten treatment sessions, the synergistic use of Tecar therapy and LLLT after a long-term follow-up period could lead to more durable therapeutic effects in improving these outcomes for individuals with diabetes.

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