EARLY BIOMARKERS IN DIABETIC PERIPHERAL NEUROPATHY: CURRENT ADVANCES AND FUTURE PERSPECTIVE

Abstract

Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus and a major cause of disability worldwide. It affects sensory, motor, and autonomic nerves and significantly reduces patients’ quality of life. Early diagnosis of DPN remains difficult because clinical symptoms often appear after irreversible nerve damage has already occurred. Therefore, identifying reliable early biomarkers has become an important area of modern neurological and endocrinological research. Recent studies have demonstrated that inflammatory cytokines, oxidative stress markers, metabolic abnormalities, and neurovascular changes are strongly associated with the development and progression of DPN. Biomarkers such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), malondialdehyde (MDA), and advanced glycation end products (AGEs) may contribute to earlier detection of neuropathic changes. Furthermore, novel neurospecific markers like neurofilament light chain (NfL) and emerging technologies including corneal confocal microscopy (CCM) and artificial intelligence-based prediction models show promising diagnostic value. This review article summarizes current scientific evidence regarding early biomarkers involved in diabetic peripheral neuropathy and discusses future perspectives for improving diagnosis, prevention, and personalized treatment strategies.