Algorithm for the diagnosis and treatment of patients with diabetic polyneuropathy. Expert Council Resolution (March 1, 2025)

The Expert Council has developed an algorithm for the diagnosis, treatment, and follow-up of patients with diabetes mellitus complicated by diabetic polyneuropathy (DPN), intended for use in both outpatient and inpatient settings. Particular emphasis is placed on the importance of early detection of DPN and interdisciplinary collaboration among specialists. The proposed algorithm includes recommendations for screening, clinical and instrumental diagnostics, risk stratification, and therapy selection based on the neuropathy phenotype, as well as the staged application of pathogenetic and symptomatic treatments, criteria for evaluating effectiveness, and indications for therapy continuation or adjustment. Experts highlighted the pathogenetic rationale for prescribing agents with neuroprotective and co-analgesic effects, including ipidacrine, which has proven efficacy and a legal basis for use in DPN. The algorithm promotes the standardization of care and can be integrated into the clinical practice of primary care physicians, endocrinologists, and neurologists.