Global prevalence of diabetes-related neuropathy and vascular complications: A systematic review and meta-analysis

Diabetic peripheral neuropathy (DPN) and peripheral artery disease (PAD) are common neurovascular complications of diabetes; however, evidence on their pooled prevalences remains unclear. We estimate the pooled prevalences of DPN and PAD in people with diabetes, and to ascertain related risk factors. A systematic review and meta-analysis was conducted using PubMed, Embase, Scopus, Web of Science, and gray literature sources (Google Scholar and Garuda), with searches completed up to December 10, 2025. Across 155 studies, the pooled prevalence was 36 % for DPN and 19 % for PAD. Compared to developed countries, developing countries had higher prevalences of DPN (25 % vs. 39 %) and PAD (10 % vs. 24 %). A meta-regression indicated that chronic kidney disease (CKD) comorbidity was associated with a higher DPN prevalence (β = 0.024; 95 % CI 0.004-0.042). The prevalence of DPN was higher in the combination method (39 %) than in symptom assessment (36 %) or symptoms alone (30 %). Clinical practice should emphasize regular foot examinations, early vascular assessment, and patient education, particularly in developing countries and among people with CKD, to ensure timely detection and effective prevention of diabetes-related complications.