A COMPREHENSIVE REVIEW ON DIABETIC NEUROPATHY AND ITS CLINICAL IMPLICATIONS

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia due to defects in insulin secretion, insulin action, or both. Among its chronic complications, diabetic neuropathy (DN) is one of the most prevalent and disabling, affecting nearly half of diabetic patients during their lifetime. DN represents a group of distinct clinical syndromes that result from damage to peripheral nerves caused by long-term metabolic and vascular disturbances associated with diabetes. The pathogenesis of DN is complex and multifactorial, involving chronic hyperglycemia, oxidative stress, microvascular insufficiency, inflammatory pathways, and neuronal apoptosis. Clinical manifestations vary from mild sensory loss to severe pain, weakness, and autonomic dysfunction affecting multiple organ systems. The condition significantly impairs quality of life, increases morbidity and mortality, and is a leading cause of non-traumatic amputations. Early diagnosis and multidisciplinary management are crucial in reducing disease progression and complications. This review aims to comprehensively discuss the pathophysiology, classification, clinical features, diagnosis, complications, and management of diabetic neuropathy.