How Red Light Therapy Can Support People Living With Diabetes
Managing diabetes can be challenging for anyone diagnosed with this increasingly common disorder and comes with a series of challenges. It is complex and can change over time. This may be due to the fact that every person with diabetes is unique. At the start, diet and exercise may be enough, however, most people will need further interventions to support their diabetic health. With that said, there is not a one-size-fits-all approach regarding treatment and therapeutic support for diabetes. Taking an active role in your treatment and the more you know about diabetes management, the better off you'll be. Take this opportunity to understand alternative treatments in managing your diabetes care and the management strategy that works for you.
What is Diabetes?
Diabetes is a chronic health condition in which blood glucose is not adequately managed by the body either due to the inability of the pancreas to produce insulin, or a level of insulin resistance that has outpaced the body’s ability to keep up with the insulin demand. In both scenarios glucose can build up in the blood, which can lead to a range of health issues.
According to diabetes.org, about 2% of people have several types of diabetes. Type 1, type 2 and gestational diabetes are the most common types of diabetes.
- Type 1 diabetes
- Type 2 diabetes
- Gestational diabetes
- Maturity onset diabetes of the young (MODY)
- Neonatal diabetes
- Wolfram Syndrome
- Alström Syndrome
- Latent Autoimmune diabetes in Adults (LADA)
- Type 3c diabetes
- Steroid-induced diabetes
- Cystic fibrosis diabetes
The approach to treating diabetes is vastly different; depending on what type it is. Often referred to as Juvenile diabetes in previous literature; type 1 diabetes is suspected to be caused by an autoimmune disorder in which the body mistakenly destroys the Langerhans cells in the pancreas.
The second and much more common type of diabetes which is most often diagnosed in adulthood has a completely different source as primarily being caused by dietary and lifestyle choices. A vicious cycle begins the process; as we eat the Standard American Diet (now becoming more ubiquitous in Canada and Europe) which is defined by the overconsumption of processed carbohydrates. This in turn leads to an overworked pancreas which is constantly fighting to produce insulin in order to control mounting levels of blood glucose. This causes hyperinsulinemia - which in turn causing insulin resistance - meaning that increasing levels of insulin are needed in order to keep blood glucose levels within normal ranges. As the body begins to fall short of being able to keep up with mounting levels of blood sugar, and the pancreas begins to anticipate this by pumping insulin out preemptively. The cycle continues and becomes the chronic condition known as metabolic syndrome characterized by abdominal fat, high cholesterol, hypertension and of course high blood glucose. The good news is that by making changes to one’s diet and lifestyle, with the help of a registered dietitian or other qualified healthcare professional, type 2 diabetes can often be successfully managed.
Red light and near-infrared (NIR) light for diabetic care
Diabetes can interfere with the body’s production of nitric oxide and ultimately can disrupt normal blood flow. This is one of the explanations why diabetics are more likely to develop peripheral artery disease, a cardiovascular illness in which restricted blood vessels decrease blood flow to the limbs. Diabetic neuropathy is a peripheral nervous system condition that causes loss of sensation in the extremities, usually in the feet.
Diabetic foot ulcers (DFUs) are a disabling and common complication of diabetes that has a negative influence on one's quality of life and can lead to amputation and even premature death. Red light therapy (RLT), also known as low-level laser therapy (LLLT), has been shown to treat DFU. The evidence from this randomized double-blind placebo-controlled clinical trial, “demonstrated an increase in skin microcirculation that was due to athermic laser irradiation in patients with diabetic microangiopathy,” (Schindl A, et al.,1998). The intention of the study was to address the diabetic foot problems that were a result of angiopathy and neuropathy that accounted for 50% of all diabetic-related non-traumatic amputations. This study found that the low-level laser irradiation, in the patients with diabetic microangiopathy, resulted in “a statistically significant rise in skin temperature, whereas in the sham-irradiated control group, a slight but significant drop in temperature was found,” (Schindl A, et al.,1998). The increase in circulation was able to accelerate healing. This confirms the effects of LLLT increasing blood flow in areas of the body to which it is applied. Subsequently, having a profound implication for the treatment of slow-healing wounds found in diabetic patients.
In clinical studies, Red and NIR light therapy was found to help relieve discomfort associated with diabetic-related ailments such as supporting patients with dire diabetic neuropathy (DDN), a common complication of diabetes. LLLT was found to improve nerve function and “skin microcirculation in diabetic persons,”(Zang K, et al., 2011). Healing foot ulcers is one of the most promising outcomes of the benefits of red and near-infrared light treatment for diabetics.
In this pilot study, prior to regular care and dressing, laser treatment was administered once a week to the participants in the study. Patients with similar DFUs and clinical features were treated with conventional therapy as a control group. The purpose of the selected pilot study was to “investigate the efficacy of an advanced class IV laser (emitting four wavelengths) on Wagner stage 1 and 2 neuroischemic DFUs of five patients with type 2 diabetes who were unresponsive to conventional treatment for at least 12 weeks,” (Maltese G, et al., 2015). Despite the limitations of this proof-of-concept investigation, the findings suggest that laser therapy provided by a class IV laser can have a considerable impact on the healing process of neuroischemic DFUs that have been resistant to normal treatment.
In terms of tissue regeneration and increased blood circulation, the following effects were assumed to be the mechanism of laser action:
- Increased activity of some cells, such as leukocytes and phagocytes, and increased calcium in the cell cytoplasm
- Interaction with cytochromes, stimulating redox activity in the cellular respiratory chain and resulting in cell activation
- Accelerated cell division and growth
- Activation of protein and cytokine synthesis
- Stimulation of production of adenosine triphosphate (ATP), which enhances the cells’ mitotic activity;
- Relaxation of the vessel walls (vasodilatation) by photolysis of complexes such as nitric oxide
The effects of diabetic peripheral neuropathy (DPN) on both type 1 and type 2 diabetes were investigated in this study. The effects of LLLT on, “motor and sensory nerve conduction velocity (NCV), and foot skin microcirculation," (Yamany, A & Sayed H, 2012) was examined amongst the 30 participants involved, . It was concluded that "in the laser group, the microcirculation at the three points was increased significantly with no significant change in the control group; post-treatment measurement comparison between groups found a highly significant difference in favor of the laser group,” (Yamany, A & Sayed H, 2012) ). DPN treatment focused on improving microcirculation and strengthening nerve regeneration with red/NIR light therapy as the wound-healing biological effects would promote blood flow and reduce inflammation. Ultimately, light therapy will improve blood circulation by supporting the growth of small capillaries in the targeted treatment areas.
In the research cited; it was hypothesized that the increase in cutaneous blood flow is reflected by a comparable impact at the endoneurial level, implying that an increase in nerve blood flow is a mechanism by which a laser produces peripheral nerve function improvement. An intriguing finding to regenerate nerves!
Nerve regeneration, blood circulation… What more can Red Light Therapy do for diabetic health?
According to the research, red light therapy has been known to restore diabetic patients' normal healing potential by stimulating mitochondria and improving ATP generation. By addressing mitochondrial dysfunction, you have the opportunity to energize cells and trigger a cascade of positive biological processes and increased health.
When there is a chronic blood sugar imbalance, cells can become stressed, unable to function correctly, and unable to repair themselves. Blood sugar imbalances are known to produce oxidative stress, which can lead to inflammation. According to these findings, near-infrared light serves as an antioxidant and decreases inflammation. One of the main reasons for diabetic neuropathy is a lack of cellular energy, often known as mitochondrial dysfunction, therefore restoring normal mitochondrial activity is important.
In this 2013 randomized controlled trial, comparing before and after LLLT treatments, diabetic patients who received laser therapy had better neuropathy outcomes than diabetic patients who received the placebo. To acquire repeatable outcomes, more research is needed to evaluate different types of lasers, as well as variable dosage and exposure levels required in different phases of diabetic neuropathic care. Overall, LLLT and wound healing are an intricate part of diabetic care. It is aimed at reversing the loss of tissue integrity in diabetic patients.
Red Light Therapy can be looked at as a valuable adjunct treatment for addressing the issues caused by diabetes; whether it is to manage symptoms or help prevent further damage, or speed up healing. The growth of healthy tissue can be supported with light therapy as the mitochondrial activity gets restored and then may assists to repair skin ulcers and relieve neuropathic discomfort, as well as keep the peripheral nervous system running smoothly. Red light therapy is a natural and safe treatment that can help your body's natural healing systems work more effectively. Always check with your healthcare provider before using any new treatment regimen for diabetes.
Read more about red light therapy and diabetic retinopathy and wound healing and improving the appearance of scars on our blog page.
Are you ready to take charge of your health? Today is the day to get a Rouge red light therapy device!
Andreas Schindl, Martin Schindl, Heidemarie Schön, Robert Knobler, Liselotte Havelec, Liesbeth Schindl; Low-Intensity Laser Irradiation Improves Skin Circulation in Patients With Diabetic Microangiopathy. Diabetes Care 1 April 1998; 21 (4): 580–584. https://doi.org/10.2337/diacare.21.4.580
Bashiri H. Evaluation of low level laser therapy in reducing diabetic polyneuropathy related pain and sensorimotor disorders. Acta Med Iran. 2013;51(8):543-547. Published 2013 Sep 9.
Centers for Disease Control and Prevention. National diabetes statistics report, 2017. Centers for Disease Control and Prevention website. www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf External link (PDF, 1.3 MB) . Updated July, 18 2017. Accessed August 1, 201
Cheng Y, Du Y, Liu H, Tang J, Veenstra A, Kern TS. Photobiomodulation Inhibits Long-term Structural and Functional Lesions of Diabetic Retinopathy. Diabetes. 2018;67(2):291-298. doi:10.2337/db17-0803
Chaves ME, Araújo AR, Piancastelli AC, Pinotti M. Effects of low-power light therapy on wound healing: LASER x LED. An Bras Dermatol. 2014;89(4):616-623. doi:10.1590/abd1806-4841.20142519
Cg SK, Maiya AG, Hande HM, Vidyasagar S, Rao K, Rajagopal KV. Efficacy of low level laser therapy on painful diabetic peripheral neuropathy. Laser Ther. 2015;24(3):195-200. doi:10.5978/islsm.15-OR-12
Lorne H. Zinman, Mylan Ngo, Eduardo T. Ng, Khin T. Nwe, Sven Gogov, Vera Bril; Low-Intensity Laser Therapy for Painful Symptoms of Diabetic Sensorimotor Polyneuropathy: A controlled trial. Diabetes Care 1 April 2004; 27 (4): 921–924. https://doi.org/10.2337/diacare.27.4.921
Houreld NN. Healing of diabetic ulcers using photobiomodulation. Photomed Laser Surg. 2015;33(5):237-239. doi:10.1089/pho.2015.9847
Maltese G, Karalliedde J, Rapley H, Amor T, Lakhani A, Gnudi L. A pilot study to evaluate the efficacy of class IV lasers on nonhealing neuroischemic diabetic foot ulcers in patients with type 2 diabetes. Diabetes Care. 2015;38(10):e152-e153. doi:10.2337/dc15-0774
Ebrahimpour-Malekshah R, Amini A, Zare F, et al. Combined therapy of photobiomodulation and adipose-derived stem cells synergistically improve healing in an ischemic, infected and delayed healing wound model in rats with type 1 diabetes mellitus. BMJ Open Diabetes Res Care. 2020;8(1):e001033. doi:10.1136/bmjdrc-2019-001033
Feitosa MC, Carvalho AF, Feitosa VC, Coelho IM, Oliveira RA, Arisawa EÂ. Effects of the Low-Level Laser Therapy (LLLT) in the process of healing diabetic foot ulcers. Acta Cir Bras. 2015;30(12):852-857. doi:10.1590/S0102-865020150120000010
Fleury N, Geldenhuys S, Gorman S. Sun Exposure and Its Effects on Human Health: Mechanisms through Which Sun Exposure Could Reduce the Risk of Developing Obesity and Cardiometabolic Dysfunction. Int J Environ Res Public Health. 2016;13(10):999. Published 2016 Oct 11. doi:10.3390/ijerph13100999
Gong L, Zou Z, Huang L, Guo S, Xing D. Photobiomodulation therapy decreases free fatty acid generation and release in adipocytes to ameliorate insulin resistance in type 2 diabetes. Cell Signal. 2020;67:109491. doi:10.1016/j.cellsig.2019.109491
Obradović R, Kesić L, Mihailović D, Jovanović G, Antić S, Brkić Z. Low-level lasers as an adjunct in periodontal therapy in patients with diabetes mellitus. Diabetes Technol Ther. 2012;14(9):799-803. doi:10.1089/dia.2012.0027
Tatmatsu-Rocha JC, de Castro CA, Sene-Fiorese M, Parizotto NA. Light-emitting diode modulates carbohydrate metabolism by pancreatic duct regeneration. Lasers Med Sci. 2017;32(8):1747-1755. doi:10.1007/s10103-017-2245-3
Houreld NN. Shedding light on a new treatment for diabetic wound healing: a review on phototherapy. ScientificWorldJournal. 2014;2014:398412. Published 2014 Jan 6. doi:10.1155/2014/398412