CLINICAL AND PATHOGENETIC ASPECTS OF DIABETIC PERIPHERAL POLYNEUROPATHY IN TYPE 2 DIABETES MELLITUS AND OPTIMIZATION OF TREATMENT

Abstract

Type 2 diabetes mellitus (T2DM) is one of the leading chronic metabolic diseases worldwide and represents a major public health challenge. The incidence of T2DM continues to increase annually, resulting in a growing number of patients with chronic complications. Diabetic peripheral polyneuropathy (DPPN) is one of the most common microvascular complications, occurring in approximately 30–50% of patients with long-standing diabetes. It is characterized by progressive damage to peripheral nerves caused by chronic hyperglycemia, oxidative stress, inflammatory reactions, endothelial dysfunction, mitochondrial impairment, and microvascular ischemia. Clinically, DPPN manifests as numbness, burning pain, paresthesia, reduced vibration sensitivity, muscle weakness, and impaired tendon reflexes, significantly decreasing patients' quality of life and increasing the risk of diabetic foot syndrome and lower-limb amputation. Early diagnosis and pathogenetically oriented therapy are therefore essential for preventing irreversible neurological damage.