The effectiveness of balneotherapy on pain, walking, and function in patients with diabetic neuropathy: a prospective observational study.

The treatment of type 2 diabetes patients with diabetic neuropathy using pharmacological and non-pharmacological measures remains a current topic. The aim of this study is to evaluate the effect of comprehensive medical rehabilitation programs that include natural therapeutic factors (carbonated natural mineral water) on pain, gait, and functional status in these patients. Fifty patients diagnosed with type 2 diabetes and diabetic neuropathy in the lower limbs participated in the study. Half of them (DZ-PT) underwent treatment consisting of physical exercises, physiotherapy, and terrain cure, while the other half (DZ-CMW) received the same treatment plus baths with carbonated natural mineral water. Patients were evaluated using assessment scales for pain Visual Analogue Scale (VAS), the 10-meter walking test (W10m), lower limb muscle strength (FM), Functional Independence Measure (FIM), and Neuropathy Disability Score (NDS). The results showed a statistically significant reduction in pain assessed by VAS at the end of the treatment, persisting for three months (p-values < 0.001 between the two groups), with a greater reduction in the DZ-CMW group. Similarly, a significant improvement in gait, evaluated by W10m, was found both at the end of the treatment and at 3 months after its completion, with greater improvement in the DZ-CMW group. In conclusion, patients with type 2 diabetes with diabetic neuropathy can benefit from comprehensive medical rehabilitation programs periodically, including therapeutic natural factors, at balneoclimacteric resorts, alongside medication, dietary regimen, and physical activity.