Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2023; 14(6): 741-757
Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.741
Issues and challenges in diabetic neuropathy management: A narrative review
Che Aishah Nazariah Ismail
Che Aishah Nazariah Ismail, Department of Physiology, School of Medical Sciences, University Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
Author contributions: Ismail CAN did the database search and wrote the manuscript.
Conflict-of-interest statement: No conflict of interest is identified while preparing the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Che Aishah Nazariah Ismail, PhD, Lecturer, Department of Physiology, School of Medical Sciences, University Sains Malaysia Health Campus, Kota Bharu, Kubang Kerian 16150, Kelantan, Malaysia. aishahnazariah@usm.my
Received: January 3, 2023
Peer-review started: January 3, 2023
First decision: January 17, 2023
Revised: February 24, 2023
Accepted: April 11, 2023
Article in press: April 11, 2023
Published online: June 15, 2023
Processing time: 163 Days and 3.2 Hours
Abstract

Diabetic neuropathy (DN) is a devastating disorder with an increasing prevalence globally. This epidemic can pose a critical burden on individuals and com-munities, subsequently affecting the productivity and economic output of a country. With more people living a sedentary lifestyle, the incidence of DN is escalating worldwide. Many researchers have relentlessly worked on ways to combat this devastating disease. Their efforts have given rise to a number of commercially available therapies that can alleviate the symptoms of DN. Unfortunately, most of these therapies are only partially effective. Worse still, some are associated with unfavorable side effects. This narrative review aims to highlight current issues and challenges in the management of DN, especially from the perspective of molecular mechanisms that lead to its progression, with the hope of providing future direction in the management of DN. To improve the approaches to diabetic management, the suggested resolutions in the literature are also discussed in this review. This review will provide an in-depth understanding of the causative mechanisms of DN, apart from the insights to improve the quality and strategic approaches to DN management.

Keywords: Diabetic neuropathy; Pathophysiology; Diabetic management; Diabetic medication

Core Tip: This review elaborates on the current aspects regarding diabetic neuropathy (DN), especially issues pertaining to the treatments and current challenges in the management of DN with some suggested recommendations on strategies to slow down DN progression. In order to increase the understanding of DN, current lines of therapy, the understanding of its pathophysiology, and future direction of its management are also included. Perhaps, this review may provide insights to understand the important information regarding DN and give ideas for improvement of treatments and management of DN.