Effect of Vagus Nerve Stimulation on Pain Intensity, Nerve Conduction Studies and Functional Outcomes in Diabetic Peripheral Neuropathy Patients

Inclusion Criteria * Thirty patients diagnosed with diabetic neuropathy of both genders. * Age range between 45 and 60 years. * Presence of numbness and/or pain in the feet with no other identifiable cause. * Pain characterized as stabbing, electric shock-like, or burning in nature. * Presence of glove-stocking sensory changes and abnormal sensations in the distal lower limbs. * Ability to ambulate independently without assistance. * Patients under full medical control. * Hemoglobin A1c levels ranging from 6.5% to 7%. * History of diabetes mellitus for more than 5 years. Exclusion Criteria * Implantation of cardiac pacemakers or other electrical stimulation devices. * Presence of sinus bradycardia, sick sinus syndrome, or other cardiac arrhythmias. * Lumbar radiculopathy. * Psychiatric or mental disorders or history of seizures. * Visual or auditory impairments or tremors affecting balance. * Presence of other neuromuscular disorders. * Foot deformities or active foot ulcers. * History of lower limb surgical operations.