Zaineb Fourati

Background: Diabetic foot ulcers (DFUs) are among the most serious and costly complications of diabetes mellitus, often leading to infection, amputation, and a significant decline in quality of life. Despite conventional treatment strategies, many DFUs remain slow to heal or unresponsive, prompting interest in complementary therapies. Low-Level Laser Therapy (LLLT) has emerged as a non- invasive, painless, and potentially effective modality to enhance ulcer healing through mechanisms like improved microcirculation and tissue regeneration. Objective: This systematic review aims to evaluate the effectiveness of Low-Level Laser Therapy (LLLT) in promoting the healing of diabetic foot ulcers in patients with type 2 diabetes. Methods: A systematic literature search was conducted using PubMed and Elsevier databases up to April 2025. Studies were included if they investigated the use of LLLT in treating DFUs in type 2 diabetic patients. Inclusion criteria focused on randomized controlled trials and clinical studies available in English or French. Study selection followed the PRISMA 2020 guidelines, and a narrative synthesis of outcomes was performed. Risk of bias was assessed using the Cochrane Collaboration’s tool. Results: Eight studies met the inclusion criteria, including randomized controlled trials, systematic reviews, and clinical studies, with sample sizes ranging from 7 to 413 participants. The findings consistently demonstrated that LLLT significantly reduced ulcer size, accelerated healing time, improved pain management, and enhanced granulation without reported adverse effects. While heterogeneity existed in laser parameters and treatment protocols, the overall quality of evidence was considered high. Conclusion: LLLT appears to be a safe, effective, and well-tolerated adjunctive treatment for diabetic foot ulcers. Its ability to promote wound healing and reduce complications offers promising implications for clinical practice. However, further large-scale and standardized trials are needed to confirm these findings and establish optimal treatment guidelines.