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The factors considered responsible for the challenges in recognition and timely diagnosis of DPN include: a) the insidious course of disease manifesting with non-specific symptoms and signs mimicking many other diseases, b) a lack of consensus on optimal screening and diagnostic procedures, c) the absence of a well-established diagnostic scrutiny, and d) the poor acceptance of guidelines and insufficient awareness of the disease among physicians (22, 23, 25, 30, 56–58)