Diabetic Peripheral Neuropathy – From Early Symptoms to Long-Term Complications and Treatment Strategies

Abstract

Introduction:
Diabetic peripheral neuropathy (DPN) is a common diabetes complication causing sensory dysfunction, neuropathic pain, gait impairment, foot ulcers, amputation risk, and lower quality of life; it may initially be silent or hard to recognize.

Aim of the study:
This review synthesized knowledge on DPN symptoms, pathophysiology, diagnosis, complications, treatment, prevention, and future directions.

Materials and methods:
Relevant sources were identified through PubMed and Google Scholar; this article was prepared as a narrative review, not a systematic review or meta-analysis.

Results:
DPN is a multifactorial, progressive, length-dependent sensorimotor polyneuropathy involving metabolic, vascular, inflammatory, oxidative, mitochondrial, and neuroglial mechanisms. Hyperglycemia, dyslipidemia, obesity, insulin resistance, microvascular injury, and genetics may damage nerve fibers. Manifestations include pain, sensory symptoms, impaired protective sensation, gait instability, deformity, ulceration, amputation risk, sleep disturbance, emotional burden, and reduced functioning. Management includes metabolic control, screening, foot protection, pain therapy, rehabilitation, lifestyle change, education, and emerging therapies, but current treatment mainly relieves symptoms and cannot reliably reverse established nerve damage.

Conclusions:
DPN requires early recognition, individualized assessment, realistic goals, and multidisciplinary care targeting pain, foot safety, mobility, function, and quality of life. Research should validate biomarkers, improve risk stratification, and develop disease-modifying therapies.