Diabetic Peripheral Neuropathy: An Updated Review Article for Healthcare Professionals

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Saud Mutlaq Saud Al-Ruwais, Salman Mkazi Sulaiman Alshammri, Abdulmajeed Obaid Abdullah Alotaibi, Hissah Muteb Dakhilallah Albalawi, Nadyah Ali Azeb Al Shomrani, Hussen Bahws Saeed Alhsnani, Ghazi Waleed Serouji, Raid Ali Alzahrani, Heba Farhan Hussein Al-Anzi, Rahma Ibrahim Abdullah Daghriri, Raed Mubarak Alshaikhi.

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus, leading to sensory, motor, and autonomic dysfunction. It manifests pain, numbness, paresthesia, and progressive loss of protective sensation, increasing the risk of foot ulcers and amputations. The exact pathophysiology remains unclear, but metabolic, neurovascular, and inflammatory mechanisms contribute to nerve damage.


Aim: To provide healthcare professionals with an updated review of the epidemiology, pathophysiology, diagnosis, and management of DPN, highlighting early recognition and prevention strategies.


Methods: A comprehensive literature review was conducted using peer-reviewed studies on diabetic neuropathy. Epidemiological data, risk factors, diagnostic approaches, and therapeutic interventions were analyzed to provide an evidence-based update.


Results: DPN affects 50-66% of individuals with diabetes over their lifetime. Early diagnosis relies on clinical assessment, including small and large fiber testing and monofilament exams. Persistent hyperglycemia, oxidative stress, and inflammatory processes contribute to nerve damage. Tight glucose control in type 1 diabetes reduces DPN risk by up to 78%, whereas in type 2 diabetes, the benefit is more limited. Multimodal management, including glycemic control, lifestyle modifications, foot care, and symptomatic treatment, can reduce complications and improve patient outcomes.


Conclusion: DPN is a major cause of morbidity and disability in diabetic patients. Early diagnosis and intervention are critical to prevent complications. Comprehensive management strategies, incorporating glucose control, patient education, and targeted pharmacological treatments, are essential for reducing disease burden and improving quality of life.

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