Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and 2 diabetes. It is a leading cause of lower-limb amputation and disabling neuropathic pain. Amputations in patients with diabetes have a devastating effect on quality of life and are associated with an alarmingly low life expectancy (on average only 2 years from the amputation). Amputation also places a substantial financial burden on health-care systems and society in general. With the introduction of national diabetes eye screening programmes, the prevalence of blindness in working-age adults is falling. This is not the case, however, with diabetes related amputations. In this Review, we appraise innovative point-of-care devices that enable the early diagnosis of DPN and assess the evidence for early risk factor-based management strategies to reduce the incidence and slow the progression of DPN. We also propose a framework for screening and early multifactorial interventions as the best prospect for preventing or halting DPN and its devastating sequelae.

中文翻译：

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糖尿病周围神经病变：诊断和筛查及早期干预策略的进展。

糖尿病周围神经病（DPN）是1型和2型糖尿病的常见并发症。这是下肢截肢和致神经性疼痛致残的主要原因。糖尿病患者的截肢对生活质量具有毁灭性影响，并且与令人震惊的低预期寿命有关（平均距截肢仅2年）。截肢还给整个卫生保健系统和整个社会带来了沉重的财务负担。随着国家糖尿病眼科筛查计划的推出，在工作年龄的成年人中失明的患病率正在下降。但是，与糖尿病相关的截肢手术并非如此。在这篇评论中，我们评估了创新的即时医疗设备，这些设备可实现DPN的早期诊断，并评估基于早期危险因素的管理策略的证据，以减少DPN的发生率并减缓其发展。我们还提出了一个筛查和早期多因素干预措施的框架，作为预防或停止DPN及其毁灭性后遗症的最佳前景。