Innovative microfluidic technologies in precision research and therapy development in diabetic neuropathy: a narrative review

Diabetic neuropathy is a prevalent complication of diabetes mellitus and is characterized by progressive nerve damage that results in sensory and motor deficits. Although traditional in vitro models have provided valuable insights, they often lack the complexity needed to fully mimic the pathophysiology of DN. Microfluidic technology offers sophisticated platforms that focus on simulating the neural environment, isolating axons, simulating axonal interactions with Schwann cells, simulating blood–nerve barrier dynamics, and integrating nerve-target tissue interactions to better recapitulate the physiological and pathological conditions of the peripheral nervous system affected by diabetes, potentially revolutionizing DN research. This review explores the application of microfluidic platforms in neurobiology research, focusing on their ability to model key aspects such as axonal degeneration, myelination deficits, blood–nerve barrier dysfunction, and interactions between nerves and target tissues. Microfluidic devices enable precise control over the cellular microenvironment, facilitating studies on how factors such as high glucose levels, oxidative stress, and inflammation contribute to nerve damage in DN. Perspectives on challenges and future directions are discussed, including the need for enhanced biomimicry, standardized experimental protocols, and integration with patient-derived cells for personalized medicine approaches. Overall, microfluidic platforms represent a promising toolset for advancing our understanding of diabetic neuropathy pathogenesis, accelerating the development of therapies, and ultimately alleviating the burden of diabetic neuropathy on patients.