Innovative strategies for diabetic peripheral neuropathy: From clinical management to emerging bioengineering solutions

Diabetic peripheral neuropathy (DPN) is a common, incurable complication of diabetes that causes sensory loss, pain, and motor problems. Conventional treatments like blood glucose management, pain relief, and neuroprotective drugs have limited success and do not prevent disease progression. Advances in neurobiology, regenerative medicine, and bioengineering have led to novel therapies that target underlying mechanisms and promote regeneration. Monitoring and evaluating the onset and progression of DPN are essential for effective clinical management. Given rapid advances in understanding DPN and developing new treatments, a comprehensive review that covers clinical progress, molecular pathology techniques, and emerging bioengineering strategies is both timely and essential. This review addresses: (1) DPN pathophysiology; (2) drug therapies from clinical trials since 2020; (3) animal models used in DPN research; (4) progress and challenges in biomaterial-based drug delivery systems; (5) developments and limitations of microfluidic platforms for DPN modeling; and (6) bioengineered devices used for DPN diagnosis and monitoring. Integrating clinical insights, molecular techniques, and bioengineering innovations seeks to create a forward-looking framework for next-generation DPN treatment and management.