Introduction: Symmetrical peripheral polyneuropathy in diabetes may have sensory or motor form, and may affect both thick and thin nerve fibers. Damage to nerve fibers, after a latent period, brings about, in its advanced period, symptoms which are very distressing for patients. The most bothersome include chronic pain, caused by damage to thin C fibers. The other typical symptoms are: burning sensation, paresthesia and numbness, all o them belonging to scale of sensory disorders (Total Symptom Score-TSS). Aim: Evaluation of the effects of: 1) TENS. 2) alpha-lipoic acid-co-factor of pyruvate dehydrogenase, which is known to be effective in diabetic neuropathy. 3) concomitant use of TENS and alpha-lipoic acid-in order to reduce sensory symptoms in the TSS scale. Material and Methods: The study was conducted on patients with symptoms of symmetrical peripheral sensory and motor polyneuropathy of lower limbs. During the first and last visit sensations of pain, vibrations and severity of neuropathic symptoms were examined, according to TSS and VAS scale. Results: After treatment by infusing alpha-lipoic acid the average point result in the TSS scale has decreased to 62,4% of the initial value (p< 0,001 Student's T test). After TENS treatment the average point result has decreased to 82,9% of the initial value. Combined use of TENS and alpha-lipoic acid infusion has resulted in reducing sensory symptoms, according to TSS scale, to 56,4% of the initial value (p< 0,001). On the basis of the measurements by biothesiometer [mV] it has been found that alpha-lipoic acid lowers threshold for vibration sensation, on average to 88.7% of the initial value (p< 0,05). Conclusions: TENS therapy may be useful for the purpose of reducing sensory symptoms in symmetrical peripheral diabetic polyneuropathy of the lower limbs. Combined use of alpha- lipoic acid and TENS therapy has a stronger therapeutic effect than any of these methods in isolation.
