Diabetic neuropathy is defined as a clinically or subclinically demonstrable disorder which includes manifestations in the somatic and/or autonomic parts of the peripheral nervous system that are classified according to the areas involved. Pain is a very disturbing symptom reducing the quality of life. The distal symmetric sensory (DSP) or distal sensorimotor polyneuropathy shows the most relevant clinical manifestation. The pathogenesis of diabetic neuropathy based on the two approaches i. e. better characterization of the pathophysiological, pathobiochemical, and structural abnormalities and the performance of specific therapeutic interventions. The role of intensive diabetes therapy in treatment and prevention of diabetic neuropathy, treatment based on pathogenetic concepts and management of pain are also discussed in this chapter. Currently, there are two medications (duloxetine and pregabalin) are mainly used for the treatment of DPNP. Nonpharmacological treatment is also used in the treatment of the diabetic neuropathy. It showed a better effect of high-frequency muscle stimulation than transcutaneous electrical nerve stimulation on neuropathic symptoms.