Wang K. et al. - Photobiomodulation in the Management of Diabetes and Its Complications

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This review, published in *Annals of Medicine* in 2024, provides an overview of the use of photobiomodulation in diabetes and its complications: retinopathy, foot ulcers, peripheral neuropathy, and periodontitis. It is a narrative review, not a meta-analysis: its abstract does not report any aggregated efficacy figures.

What this study measured

Keyan Wang and his colleagues at Jilin University present a comprehensive review of the literature on photobiomodulation in diabetes mellitus. Their stated objective is threefold: to describe the disease and its complications, to outline the possible mechanisms, and to discuss the efficacy, advantages, and disadvantages.

The scope covers four complications: diabetic retinopathy, foot ulcers, peripheral neuropathy, and periodontitis. Photobiomodulation is defined here as the irradiation of tissues with low levels of red or near-infrared light. This study is indexed as a review in PubMed, not as a systematic review or a meta-analysis. The abstract does not mention a literature search strategy, the number of included studies, or a risk of bias assessment. Nor does it specify whether the protocols described combined photobiomodulation with physical exercise.

Key Findings

The summary is entirely qualitative. The only elements that can be reported without extrapolation are as follows.

The summary does not include any efficacy figures, effect sizes, or confidence intervals.
No information is provided on the number of studies included or the total sample size.
Four complications listed: diabetic retinopathy, foot ulcers, peripheral neuropathy, and diabetic periodontitis
According to the authors, conventional treatments remain limited in terms of clinical efficacy and are associated with adverse effects
Reported efficacy across a wide range of organ damage, without specific figures

The stated objective is exploratory, not prescriptive.

How Photobiomodulation Affects Metabolism

The mechanism most often proposed—and one that remains hypothetical—involves cytochrome c oxidase. This terminal complex of the mitochondrial respiratory chain is thought to absorb red and near-infrared light, which could promote the production of adenosine triphosphate. In skeletal muscle, the primary site of glucose uptake, improved mitochondrial function could influence glucose utilization. Modulation of oxidative stress and low-grade inflammation has also been suggested, as has an effect on local microcirculation. These mechanisms remain speculative: their clinical relevance has not been established by this review.

Limits You Should Know

The main limitation relates to the type of publication. A narrative review selects its literature without a pre-registered protocol or a reproducible method, which exposes it to selection bias. It does not aggregate any data and does not allow for the estimation of an effect size. The abstract provides neither the number of studies, nor sample sizes, nor treatment parameters (wavelength, dose, number of sessions). No GRADE-style assessment of the certainty of the evidence is mentioned. The indications discussed are very different: what applies to a foot ulcer does not apply to retinopathy. Finally, more recent studies have concluded that metabolic effects are inconsistent, a finding not reflected in this review.

What This Means in Practice

At this stage, there are no treatment recommendations. Photobiomodulation is in no way a substitute for antidiabetic treatment, and treatment should never be reduced or discontinued based on this type of publication. Any changes to treatment should be made exclusively by the patient’s treating physician. Self-monitoring of blood glucose levels remains necessary, particularly if regular light exposure is being considered as a complementary therapy. The complications described, particularly foot ulcers and retinopathy, require specialized medical follow-up.

Frequently Asked Questions

Can photobiomodulation replace diabetes treatment?

No. No data in this review support this, and no clinical recommendations point in that direction. Photobiomodulation is being studied as a complementary approach, never as a substitute for prescribed treatment. Any decision regarding antidiabetic treatment is up to the prescribing physician.

What is the difference between a narrative review and a meta-analysis?

A meta-analysis follows a predefined protocol and statistically combines the results of studies to produce a numerical estimate. A narrative review synthesizes the literature in a descriptive manner, without statistical aggregation or any guarantee of completeness. The level of evidence is significantly lower.

What diabetes complications does this review cover?

The abstract cites diabetic retinopathy, diabetic foot ulcers, diabetic peripheral neuropathy, and diabetic periodontitis. According to the authors, these conditions are among the leading causes of mortality and disability among people with diabetes. The review discusses the mechanisms underlying these conditions but does not provide specific figures.

Reference

Wang K, Zhao H, Zhao X, Zhang X, Zhang W, Cheng Y, Ge J. Photobiomodulation for diabetes and its complications: a review of general presentation, mechanisms, and efficacy. Annals of Medicine, 2024;56(1):2433684. PMID 39607829. DOI 10.1080/07853890.2024.2433684. https://pubmed.ncbi.nlm.nih.gov/39607829/

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.