Diabetes mellitus (DM) is one of the most urgent key problems of modern medicine with a steadily progressive increase in morbidity. Diabetic polyneuropathy (DPN) is a common complication of diabetes and leads to a decrease in the quality and life expectancy of patients, increases the risk of disability. The painful form of DPN has a particularly negative effect on the quality of life. The article discusses current views on the pathogenesis of DPN, risk factors, clinical manifestations and diagnostic methods of DPN. Most patients with DPN have vegetative disorders that are asymptomatic for a long time, however, the presence of which is associated with increased mortality. An integrated approach is important in the treatment of DPN, including both non-drug treatment methods (diet, lifestyle modification, exercise) and drug therapy aimed at correcting blood glucose levels and other risk factors, mechanisms of development and progression of DPN. The pathogenetic therapy of DPN includes the use of alpha-lipoic acid and benfotiamine, the effectiveness of which has been shown in clinical studies. As a universal antioxidant, alpha-lipoic acid is an absolutely safe drug with proven effectiveness in the treatment of pain DPN and can be recommended for use in clinical practice. Adjuvant analgesics are used as symptomatic therapy, namely drugs from the group of antiepileptic drugs (gabapentin, pregabalin) and antidepressants (duloxetine). Doctors’ knowledge of the problem of diagnosis and treatment of DPN will make it possible to detect this disease at an early stage and effectively control the progression of symptoms.