Diabetes-related neuropathy (DRN) is one of the most disabling complications of diabetes mellitus, leading to sensory deficits, chronic pain, and motor impairments that disrupt the performance of Activities of Daily Living (ADLs). These limitations contribute to dependency, reduced productivity, and diminished quality of life. Occupational Therapy (OT), through its holistic and client-centered approach, has an important role in mitigating functional decline and promoting independence. However, evidence on the effectiveness of OT interventions for individuals with DRN remains fragmented. This systematic review aimed to synthesize current evidence on OT interventions addressing ADL performance among individuals with DRN.

This review followed the PRISMA guidelines. A comprehensive literature search was conducted across PubMed, CINAHL, and Scopus databases for peer-reviewed studies published from 2010 to 2025. Eligible studies included those that (1) involved adults diagnosed with diabetes-related neuropathy, (2) examined the impact on ADL performance or functional independence, and (3) evaluated OT-based interventions. Data were extracted and analyzed thematically to identify intervention strategies, implementation characteristics, and outcome effectiveness.

Of 1,243 records identified, 27 studies met inclusion criteria. Thematic synthesis revealed four major categories of OT interventions including (1) Sensory re-education and pain management – Desensitization, mirror therapy, and sensory retraining demonstrated significant reductions in neuropathic pain and improved tactile perception; (2) Assistive devices and environmental modifications – Provision of adaptive equipment (e.g., orthotic supports, grab bars) and home safety adaptations enhanced ADL efficiency and safety; (3) Activity-focused rehabilitation – Task-oriented training targeting dressing, mobility, and household activities improved functional independence and energy conservation and (4) Psychosocial and self-management support – Education, coping strategies, and self-efficacy programs improved adherence to activity participation and emotional well-being. Collectively, these interventions improved ADL performance, pain coping, and quality of life. However, heterogeneity in intervention duration, outcome measures, and methodological rigor limited meta-analytic comparison.

Occupational Therapy plays a critical and multifaceted role in improving functional outcomes for individuals with diabetes-related neuropathy. Evidence supports the integration of sensory re-education, adaptive equipment, activity-based rehabilitation, and psychosocial interventions into comprehensive care plans. Future research should employ standardized outcome measures and randomized controlled designs to strengthen evidence for practice and policy development.