From Pain to Daily Function: A Narrative Review on Quality of Life in Diabetic

Background: Diabetic neuropathy (DN) is among the most common and disabling complications of diabetes mellitus, associated with chronic pain, sensory loss, and functional decline. Beyond physical impairment, DN substantially reduces quality of life (QoL) through emotional distress, sleep disturbances, and social limitations.

Methods: A narrative synthesis was conducted based on literature published between January 2000 and March 2025. Databases searched included PubMed, Cochrane Library, Scopus, and CINAHL. Eligible studies comprised randomized controlled trials, observational studies, systematic reviews, and meta-analyses that evaluated QoL in DN using validated instruments such as SF-36, EQ-5D, WHOQOL-BREF, Norfolk QOL-DN, and NeuroQoL. Studies focusing on diabetes complications without specific reference to neuropathy, or reporting solely pharmacological efficacy without QoL outcomes, were excluded.

Results: The global prevalence of DN ranges from 20% to 46%, varying by diagnostic method, region, and population characteristics. Painful DN significantly reduces QoL by limiting mobility, impairing sleep, and causing fatigue. Emotional distress including anxiety and depression further exacerbates symptom burden and negatively impacts adherence to treatment. Social participation and occupational functioning are also compromised. Disease-specific QoL tools, particularly the Norfolk QOL-DN, demonstrate greater sensitivity in detecting neuropathy-related impairments compared to generic measures. Evidence indicates that pharmacological treatments (pregabalin, duloxetine), exercise therapy, and cognitive-behavioral interventions improve symptom control and overall QoL. Multidisciplinary approaches combining medical, physical, and psychological care yield the most comprehensive benefits.

Conclusion: DN profoundly affects multiple dimensions of QoL. Holistic, patient-centered care strategies that integrate symptom management, psychosocial support, and functional rehabilitation are essential to improving outcomes and guiding future research.