Diabetic Peripheral Neuropathy in Children and Adolescents - Prevalence, Diagnostic Methods and Risk Factors

Diabetic peripheral neuropathy (DPN) is the most common form of acquired neuropathy. In children with type 1 diabetes, the reported prevalence of DPN varies widely, ranging from 3% to 62%, mainly due to differences in screening methodologies and patient population characteristics. While intraepidermal nerve fiber density assessment via skin biopsy remains the gold standard for detecting small fiber neuropathy, nerve conduction studies are the established diagnostic tool for large fiber involvement. However, several novel and non-invasive diagnostic tools have emerged recently, offering improved screening options for early-stage and subclinical DPN. The frequent presence of asymptomatic neuropathy in pediatric populations, combined with its limited treatment options, underscores the importance of early identification of modifiable risk factors thus reducing the risk of developing clinically significant DPN. This review provides a comprehensive overview of the current evidence on the prevalence, risk factors, and modern diagnostic approaches for DPN in children with diabetes.