Diabetic sensorimotor polyneuropathy (DSPN) is one of the most frequent and debilitating complications of diabetes, contributing substantially to morbidity and mortality. Alarmingly, up to two thirds of patients remain undiagnosed, and by the time DSPN is detected, irreversible nerve injury has often already occurred.

Research into the underlying pathophysiological mechanisms of DSPN remains limited, in part due to the difficulty and risk of obtaining nerve tissue. Nevertheless, DSPN is characterized by axonal atrophy, demyelination, loss of nerve fibers, and impaired regenerative capacity. Despite its clinical burden, there are currently no effective disease-modifying therapies. While lifestyle interventions and glycemic control remain fundamental to diabetes care, these approaches have limited impact on neuropathic pain, highlighting the urgent need for new strategies.

Advances in non-invasive, objective diagnostic methods now offer promising opportunities for the early detection and characterization of nerve damage, providing insights into disease mechanisms and supporting the evaluation of emerging therapies. At the same time, multidisciplinary approaches including pharmacological, interventional, and lifestyle based strategies are being explored to improve management and outcomes.

This Research Topic aims to bring together innovative research and reviews that advance diagnostic tools and therapeutic strategies for DSPN. We welcome contributions spanning clinical, translational, and basic research, with a focus on integrating diagnostics, pathophysiological insights, and novel interventions.

Themes of interest include, but are not limited to:

- Novel techniques for early detection and localization of nerve damage in DSPN

- Screening tools for use in both clinical and experimental settings

- Approaches to differentiate between axonal and demyelinating injury

- Pathomechanistic differences between painful and painless DSPN

- Imaging techniques of the peripheral and central nervous system in DSPN

- Biomarkers and risk factors for onset, progression, and prognosis

- Diagnostic tools providing insights into pathophysiology and therapeutic evaluation

- Pharmacological and interventional strategies for neuropathic pain

- Lifestyle interventions, including medical and surgical weight loss, and their impact on DSPN

- Emerging therapeutic approaches for prevention, treatment, and multidisciplinary management

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Frontiers in Diagnostic and Therapeutic approaches in Diabetic Sensorimotor Neuropathy, Volume II