The conundrum of diabetic neuropathies-Past, present, and future

J Diabetes Complications. 2022 Nov;36(11):108334. doi: 10.1016/j.jdiacomp.2022.108334. Epub 2022 Oct 7.


Diabetic neuropathy (DN) remains arguably the most prevalent chronic complication in people with both type 1 and type 2 diabetes, including in youth, despite changes in the current standards of clinical care. Additionally, emerging evidence demonstrates that neuropathy affects a large proportion of people with undiagnosed diabetes and/or prediabetes, as well as those with obesity. Here we summarize the latest epidemiology of DN, recent findings regarding the pathophysiology of the disease, as well as current outcome measures for screening and diagnosis, in research and clinical settings. The authors discuss novel perspectives on the impact of social determinants of health in DN development and management, and the latest evidence on effective therapies, including pharmacological and nonpharmacological therapies for neuropathic pain. Throughout the publication, we identify knowledge gaps and the need for future funding to address these gaps, as well as needs to advocate for a personalized care approach to reduce the burden of DN and optimize quality of life for all affected individuals.

Keywords: Autonomic neuropathies; Diabetic peripheral neuropathy; Epidemiology; Mechanisms; Novel risk factors; Personalized care implementation.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / therapy
  • Diabetic Neuropathies* / complications
  • Diabetic Neuropathies* / diagnosis
  • Diabetic Neuropathies* / epidemiology
  • Humans
  • Mass Screening
  • Neuralgia*
  • Quality of Life