Efficacy, Safety, and Functional Outcomes of Yoga Therapy in Diabetic Peripheral Neuropathy: A Systematic Review.

Background: Diabetic peripheral neuropathy (DPN) is a common and debilitating complication of type 2 diabetes mellitus, affecting up to 50% of patients. Standard pharmacological treatments offer limited relief and do not address the underlying pathophysiology. Yoga is a mind-body practice combining physical postures, breathing techniques, and meditation, which has demonstrated potential benefits in improving metabolic parameters and psychological well-being in DPN. Emerging evidence suggests yoga may also improve functional outcomes and alleviate symptoms in individuals with DPN. This systematic review aimed to evaluate the safety, efficacy, and clinical relevance of yoga in the management of DPN. Methods: Following PRISMA guidelines, a comprehensive search of MEDLINE/PubMed was conducted from inception to May 19, 2025, with Google Scholar searched as a supplementary source to enhance completeness. Eligible studies included published randomized controlled trials, crossover trials, quasi-experimental studies, and single-group pre-post studies assessing the effect of yoga in DPN. This systematic review included seven studies: four RCTs, one quasi-experimental study, and two single-group pre-post studies. Studies were screened and reviewed independently by two authors. Results: This systematic review included seven studies comprising a total of 227 participants. Yoga interventions ranged from 8 to 12 weeks. Patients with DPN reported improvements in neuropathic pain, balance, lower-limb strength, gait speed, and quality of life. No serious adverse events were noted. Conclusion: Yoga may be recognized as a safe and potentially effective adjunct therapy in improving symptoms and function of individuals with DPN. However, variability in study design, small sample sizes, heterogeneity in interventions and the overall high risk of bias in included randomized controlled trials, limited the ability to draw firm conclusions. Hence, larger, high-quality trials are recommended to validate the effect of yoga in DPN along with the underlying mechanisms. PROSPERO Registration Number: CRD420251241345. keywords: Balance, diabetic peripheral neuropathy, gait, neuropathic pain, quality of life, systematic review, yoga.