Diabetic neuropathy is a very common complication, and painful neuropathy often appears at the ends of the extremities, especially the lower extremities, often with a tendency to worsen at night, seriously affecting patients’ sleep as well as their quality of life, and must be taken seriously. Now, I will summarize the treatment methods for different etiologies or mechanisms based on the clinical practice of our sugar foot center. 1. Anti-oxidative stress Oxidative stress is one of the pathogenic mechanisms of diabetic neuropathy. Currently, alpha-lipoic acid is considered the most widely used strong antioxidant in clinical practice, and it is recommended to take 600 mg IV daily for 3 weeks to improve neurosensory symptoms. 2, improve microcirculation Microcirculation disorders are also one of the pathophysiological features of diabetic complications, because nerves also need blood nourishment. Prostaglandin E1 lipid microsphere carrier preparation is effective in improving spontaneous pain and sensory abnormalities in diabetic neuropathy. Another recommended drug: pancreatic kininogenase, which has the effects of improving nerve conduction speed, inhibiting platelet aggregation, preventing thrombosis and improving blood circulation. 3.Improve metabolic disorders Diabetes itself is a metabolic disorder, and research has found that aldose reductase inhibitors, such as epalrestat, have the effect of significantly improving symptoms and delaying disease progression. 4, nerve nutrition and nerve repair Active vitamin B12 preparations, such as methylcobalamin, can significantly improve the clinical symptoms, signs and nerve conduction speed of diabetic neuropathy. Of course, this is also in general, and is also formulated for specific mechanisms. When it is applied clinically, it should be seen in the context of the patient’s actual condition and the doctor’s personal experience, and should not be copied blindly! Moreover, in patients who have become gangrenous, neuropathy is only one aspect, and the specific use of the drug should also take into account the effects with other drugs. In this regard, it is advisable to visit a specialized diabetic foot unit to avoid irreparable damage caused by improper treatment.