A Call to Action for Peripheral Neuropathy Research: NIH Collaboration, Funding Gaps, and the Future of PN Treatment
Peripheral Neuropathy Affects Millions Worldwide
Peripheral neuropathy (PN) affects an estimated 30 million Americans and approximately 130 million people worldwide. There are dozens of causes, but metabolic disease — including obesity, pre-diabetes, and diabetes — is by far the leading driver of PN.
Metabolic Disease as the Leading Cause of Peripheral Neuropathy
Metabolic dysfunction plays a central role in the development of PN. Despite its widespread prevalence, the mechanisms underlying the development and progression of peripheral neuropathy remain unclear.
Why Current Treatments Are Not Enough
There are currently no sufficient treatments or cures for PN. Existing interventions primarily focus on symptom management rather than addressing root causes. This gap underscores the urgent and time-sensitive need for expanded biomedical and clinical research to better understand disease mechanisms and identify effective therapeutic targets.
NIH and NIDDK Address Gaps in Peripheral Neuropathy Research
On February 17, 2026, representatives from the Foundation for Peripheral Neuropathy met with leadership at the National Institutes of Health (NIH)’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the institute primarily responsible for diabetes research, including diabetes-related peripheral neuropathy.
NIDDK provides funding for basic/foundational, translational, and clinical research. While the institute currently supports a small portfolio of studies in the diabetic PN space, representatives acknowledged that funding remains insufficient relative to disease burden. They emphasized the importance of expanding cross-institute collaboration to maximize research impact for patients.
Cross-Institute Collaboration at NIH
NIDDK has begun partnering with other NIH institutes whose disease areas intersect with peripheral neuropathy. For example, collaboration with the National Cancer Institute (NCI) helps address chemotherapy-induced neuropathy.
These partnerships highlight the importance of coordinated federal collaboration to consolidate and strengthen research efforts across disease categories that share neuropathic complications.
The Need for More Neuroscience Investigators in Peripheral Nerve Research
Institute program directors emphasized the need for more early-career neuroscience investigators to focus on peripheral nerve research. Historically, neuroscience research has prioritized the brain and spinal cord (the central nervous system), leaving peripheral nervous system research comparatively underdeveloped.
Additionally, NIDDK stressed the need for a greater volume of high-quality grant applications in peripheral neuropathy to build a critical mass of peer-reviewed research in this field.
Research Priorities to Advance Peripheral Neuropathy Treatment
NIDDK representatives underscored several high-priority research areas that could meaningfully advance PN diagnostics, treatment, and prevention.
Understanding Disease Mechanisms and Biological Pathways
More studies are needed to uncover the pathophysiology of PN, including the biological pathways disrupted in metabolic disease that can leave to nerve degeneration. Identifying these mechanisms is essential to developing targeted interventions that can modify or halt disease progression.
Precision Medicine and Predictive Modeling
Precision medicine approaches — including predictive modeling and algorithm development — may help identify which individuals are at highest risk for developing PN. Understanding variability in disease onset and progression could enable earlier intervention and more personalized treatment strategies.
Technology Development and Long-Term Health Outcomes
Technology innovation, community engagement, health policy research, and evaluation of long-term health outcomes are also critical. Sustainable health improvements require not only new interventions, but also evidence that these interventions improve quality of life over time.
Strengthening Pre-Clinical Models and Translational Research
In the basic and foundational science realm, developing and validating improved pre-clinical animal models is essential. Better models ensure that discoveries at the laboratory “bench” can effectively translate to “bedside” diagnostics, treatments, and lifestyle interventions. Rodent and other animal models are used currently, but their relevance to specific types of neuropathy can be honed with more research.
Moving Beyond a Hyperglycemia-Only Research Approach
Historically, much PN research has centered primarily on hyperglycemia (high blood sugar) as a major driver of diabetic neuropathy. However, metabolic disease is multifactorial, and researchers must expand beyond glucose-only frameworks to better understand lipid metabolism, inflammation, mitochondrial dysfunction, and other potential contributors to the mechanism of disease.
Addressing Disease Heterogeneity and Sex Differences
Peripheral neuropathy does not develop uniformly across patients. Important gaps remain in understanding disease heterogeneity — including why some individuals rapidly develop PN following early metabolic changes, while others may live for years with elevated lipids or glucose and never develop neuropathy. Sex differences in disease progression also require further investigation.
Type 2 Diabetes and Severe Peripheral Neuropathy Risk
Type 2 diabetes is significantly more prevalent than Type 1 diabetes and is associated with more severe progression of peripheral neuropathy. However, policymakers responsible for allocating diabetes research funding are not always fully aware of this important distinction.
Understanding why some individuals develop PN soon after metabolic dysfunction begins — while others do not — remains one of the most pressing unanswered questions in the field. Increased, strategically directed funding through NIDDK may be essential to solving this puzzle and protecting millions of Americans at risk.
A Call to Action for the Peripheral Neuropathy Research Community
The Foundation for Peripheral Neuropathy encourages the research and advocacy community to take action:
- Apply for NIH Grant Opportunities
- Monitor grant opportunities and highlighted research topics at NIDDK and NIH. Prepare and submit high-quality proposals across the full translational research spectrum. More submissions — and more competitive science — are critical to building momentum in PN research.
- Advocate for Cross-Institute Federal Funding
- Encourage lawmakers to support cross-institute NIH research collaborations and consolidated funding strategies for peripheral neuropathy. Federal alignment is key to accelerating discovery.
- Build the Early Career Research Pipeline
- Invest in training programs that prepare scientists and clinicians to study the peripheral nervous system. Expanding the early-career pipeline ensures sustained progress in this field.
- Raise Awareness in Your Community
- Tell friends, neighbors, congressional representatives, and community leaders about peripheral neuropathy and the urgent need to expand research funding. Public awareness drives policy change and accelerates scientific investment.
References
- https://pubmed.ncbi.nlm.nih.gov/39801027/ Eid, Townsend…Feldman, A call to action for peripheral neuropathy research funding – Time to consolidate funding under one NIH initiative? J Peripher Nerv Syst (2025) 30(1):e12681. doi: 10.1111/jns.12681
