DIABETIC PERIPHERAL NEUROPATHY: MECHANISMS AND THERAPEUTIC APPROACHES

Abstract

This article sought to analyze the main pathophysiological mechanisms involved in the development of diabetic peripheral neuropathy and discuss the diagnostic and therapeutic approaches available in the current scientific literature. Methods: Integrative literature review conducted in PubMed, SciELO, and LILACS databases, covering publications from 2013 to 2025, with controlled descriptors combined by Boolean operators. Studies were selected in three stages (title reading, abstract analysis, and full reading) and assessed for risk of bias. Results: Strict glycemic control constitutes the treatment foundation, with more consistent benefits in type 1 diabetes. Alpha-lipoic acid stood out as the antioxidant therapy with the strongest scientific support. For neuropathic pain management, tricyclic antidepressants, duloxetine, and gabapentinoids remain first-line options, while opioids should be discouraged. The Neuropathy Impairment Score and corneal confocal microscopy showed potential for early diagnosis. Conclusions: Diabetic peripheral neuropathy is multifactorial and requires an integrated therapeutic approach, combining metabolic control, pain management, and complication prevention strategies.