Patients will be selected from those attending endocrinology and neurology clinics or hospitalized and meeting the inclusion criteria. Participants will complete the Patient Information Form, LANSS Scale, and NePIQoL forms in a quiet room in the endocrinology ward. The Ankle Brachial Index will be evaluated to exclude peripheral arterial disease. If ENMG and lab findings are unavailable, patients will be referred for necessary tests. They will receive two pairs of FIR socks to be worn at least 8 hours daily, along with usage training. Contact information will be collected. Participants will be called three times to assess compliance and comfort via VAS. After three months, they will return for a final evaluation, including an ENMG scan by neurology specialists, and complete the LANSS Scale and NePIQoL forms again.

Placebo group patients will be selected from those attending endocrinology and neurology clinics or hospitalized and meeting inclusion criteria. Participants will complete the Patient Information Form, LANSS Scale, and NePIQoL forms in a quiet room. The Ankle Brachial Index will be evaluated to exclude peripheral arterial disease. If ENMG and lab findings are unavailable, patients will be referred for necessary tests. They will receive two pairs of non-FIR socks to be worn at least 8 hours daily, along with usage training. Contact information will be collected. Participants will be called three times to assess compliance and comfort via VAS. After three months, they will return for a final evaluation, including an ENMG scan by neurology specialists, and complete the LANSS Scale and NePIQoL forms again.

Participants in the experimental group will receive two pairs of Far-Infrared Radiation (FIR) emitting socks, designed to be worn for at least 8 hours per day over a 3-month period. These socks utilize FIR technology, which is hypothesized to improve circulation, reduce neuropathic pain, and enhance quality of life in patients with diabetic peripheral neuropathy (DPN). Participants will be educated on the proper use of the socks, provided with a usage protocol, and monitored for adherence via three follow-up phone calls assessing compliance and comfort using the Visual Analog Scale (VAS). At the end of the study, participants will undergo a follow-up Electroneuromyography (ENMG) evaluation, and pain and quality of life will be reassessed using the LANSS Scale and NePIQoL forms.

The Leeds Neuropathic Symptoms and Signs Assessment Scale (LANSS) was developed by Bennett (2001) and its Turkish validity and reliability study was conducted by Yücel et al. (2004). It is used clinically to differentiate neuropathic pain from nociceptive pain and consists of a five-item pain questionnaire (max: 16 points) and a two-item sensory assessment (max: 24 points). The pain questionnaire evaluates symptoms like tingling, paresthesia, skin color changes, electric shock sensations, and burning pain. The sensory section includes Allodynia and Pinprick tests; in the Allodynia test, a cotton wisp is applied to painful and non-painful areas-if discomfort is reported in the affected region, allodynia is considered present. If the total score is ≥12, pain is classified as neuropathic, while a score <12 indicates nociceptive pain. The scale has 82-91% sensitivity and 80-94% specificity when compared to clinical diagnosis.

The Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL) was developed by Poole et al. (2009) to assess the impact of neuropathic pain on quality of life. The Turkish validity and reliability study was conducted by Acar et al. (2016) (Acar et al., 2016; Poole et al., 2009). In the original study, the internal consistency of the total NePIQoL was reported as 0.86, while in the validity and reliability study, it was found to be 0.99. The scale consists of five subdimensions: pain and other symptoms, relationships, daily activities, emotional impact of pain, and personal/self-care. It is a 42-item, 5-point Likert-type scale. The minimum possible score on the questionnaire is 42, while the maximum is 210. A score closer to 210 indicates a greater negative impact of neuropathic pain on quality of life. Conversely, lower scores reflect a better quality of life with less impact from neuropathic pain.

Electroneuromyography (ENMG) assesses nerve, muscle, and motor neuron functions by converting electrical signals into interpretable data (Rabbi et al., 2019). Used in diabetic patients for over 50 years, ENMG evaluates compound muscle action potential (CMAP) and sensory nerve action potential (SNAP), mainly for diabetic neuropathy (Najafi et al., 2018). This study will assess motor conduction in the lower extremities by recording from the abductor hallucis and extensor digitorum brevis muscles via tibial and common peroneal nerve stimulation, measuring distal latency, CMAP amplitude, and conduction velocity. Sensory conduction will be tested by stimulating sural nerves 12 cm proximally from the lateral malleolus using surface (motor) and ring (sensory) electrodes (Erbas et al., 2011; Ovayolu et al., 2008; Sarılar & Gök, 2021). ENMG will be performed at room temperature with a Medelec Synergy EMG system, ensuring skin temperature >31°C, at baseline and three months later.