Gender differences in diabetic neuropathy in the Japanese population

Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes mellitus, affecting over 30 % of patients. In Japan, where the prevalence of diabetes is notably high?especially among older adults?addressing DPN has become a clinical priority. However, little is known about gender-specific differences in DPN manifestation, progression, and self-care behaviors within the Japanese context. This study aimed to examine gender differences in DPN-related factors by reviewing Japanese literature, to inform more personalized intervention strategies. A systematic literature search was conducted using Ichushi Web and CiNii Articles up to September 2024. Inclusion criteria were studies involving patients with DPN, original articles, full-text availability, and a focus on gender differences. A total of 19 studies were selected and analysed based on participant characteristics, study design, outcome measures, and reported gender-based findings. Male patients demonstrated higher rates of smoking, alcohol use, and sarcopenia associated with DPN, while female patients showed stronger engagement in self-care practices and a higher prevalence of dyslipidemia in postmenopausal stages. Nerve conduction patterns varied by gender but were also influenced by anatomical factors. Subjective symptom reporting was more prominent in females, suggesting possible gender-related biases in symptom recognition. This review highlights significant gender-based trends in DPN risk factors and symptom expression among Japanese patients. These findings suggest the need for gender- and age-specific rehabilitation strategies, including targeted muscle preservation programs for males and enhanced educational interventions for females, especially during menopausal transitions.