Table of contents
Expand All Topics
Diabetic neuropathy
What's new
Updated 2025 ADA guidelines for the diagnosis and management of diabetic neuropathy .
Background
Overview
Definition
Diabetic neuropathy is a type of neuropathy that occurs due to microvascular disease and chronic hyperglycemia in diabetic patients.
1
Pathophysiology
Diabetic neuropathy is caused by persistent hyperglycemia, microvascular insufficiency, oxidative and nitrosative stress, defective neurotropism, and autoimmune-mediated nerve destruction in patients with diabetes mellitus.
2
Epidemiology
The incidence of diabetic neuropathy is estimated at 17.8 per 100,000 person-years in the United Kingdom.
3
Disease course
Nerve damage leads to hyperalgesia, dysesthesia, allodynia, weakness, numbness, hypoalgesia, anomalies in thermal sensation and autonomic function, foot ulcerations, gangrene, and amputations.
2
Prognosis and risk of recurrence
Diabetic neuropathy is associated with a 1.7-12-fold higher risk of amputation. In addition, autonomic neuropathy is associated with a mortality rate of approximately 25-50% at 5-10 years.
2
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of diabetic neuropathy are prepared by our editorial team based on guidelines from the American Diabetes Association (ADA 2025), the American Academy of Family Physicians (AAFP 2024), the American Academy of Neurology (AAN 2022,2010), the Diabetes Canada (DC 2018), and the European Federation of Neurological Societies (EFNS 2010).
1
2
3
4
5
6
7
8
9