Review Summary
Disease-modifying treatments for diabetic neuropathy remain elusive, and while diabetes is well established as the most important metabolic risk factor for neuropathy, controlling blood glucose levels is not enough to prevent neuropathy in individuals with type 2 diabetes. Obesity has emerged as the second most important metabolic risk factor for neuropathy, supporting exercise and weight loss as potential interventions to treat and/or prevent neuropathy, though available evidence for exercise currently outweighs data for weight loss. Importance must also be placed on accurately diagnosing neuropathy, with emphasis on clinical history and examination, though new diagnostic tests are available. Finally, guidelines have demonstrated the best treatments for neuropathic pain, including those to avoid.