Diabetic Peripheral Neuropathy: Navigating Controversies and Pioneering Advances

Abstract

This review examines Diabetic Peripheral Neuropathy (DPN), a significant complication of diabetes affecting nearly half of diabetic patients. DPN is crucial to understand due to its high prevalence and profound impact on patients’ quality of life, causing pain, sensory loss, motor dysfunction, and heightened risks of foot ulcers and amputations. As a leading cause of disability, grasping DPN’s pathophysiology, early diagnosis, and treatment options are essential for alleviating its burden. Key facets of DPN include its complex pathophysiology stemming from chronic hyperglycemia, oxidative stress, inflammation, and vascular problems that damage nerves. The review highlights the rising rates of diabetes and DPN in regions like Saudi Arabia, noting that factors such as poor glycemic control, prolonged diabetes duration, and comorbidities like hypertension significantly contribute to DPN progression. Diagnostic challenges are also addressed; traditional nerve conduction studies are gold standards yet limited in detecting early-stage neuropathy, especially small-fiber damage. Emerging methods, like skin biopsy and corneal confocal microscopy, show promise for earlier detection. Treatment mainly focuses on glycemic control and pain management without reversing nerve damage. Innovative therapies targeting DPN mechanisms include antioxidant treatments, anti-inflammatory agents, and phytomedicine, which utilizes bioactive compounds for their neuroprotective effects. The review concludes by stressing the need for ongoing research into DPN's molecular mechanisms and the development of personalized medicine approaches, which could significantly enhance patient outcomes.Keywords: Diabetic Peripheral Neuropathy; DPN induced disability; DPN Pathophysiology; DPN treatment; DPN controversies