Mapping the gut microbiota-diabetic peripheral neuropathy research landscape: a bibliometric analysis of emerging trends and translational frontiers

BACKGROUND: Diabetic peripheral neuropathy (DPN) constitutes the most prevalent chronic complication of diabetes mellitus, affecting approximately 50% of patients throughout their disease course. Accumulating evidence indicates that gut microbiota (GM) dysbiosis plays a pivotal role in DPN pathogenesis via the gut-brain axis. However, a comprehensive bibliometric analysis delineating the intellectual landscape and evolutionary trajectory of this rapidly advancing research domain remains absent. METHODS: Publications pertaining to gut microbiota and DPN were systematically retrieved from the Web of Science, PubMed, and Scopus databases (spanning 2010-2025). CiteSpace 6.4.R1 was employed to perform co-occurrence, clustering, timeline, burst detection, and co-citation analyzes, thereby visualizing the field's intellectual structure and developmental trends. RESULTS: A total of 133 publications met the inclusion criteria, exhibiting exponential growth after 2018 with an average annual increase of 35.7%. Keyword analysis identified core research clusters centered on GM, neuropathic pain, the gut-brain axis, and therapeutic interventions such as fecal microbiota transplantation (FMT), traditional Chinese medicine, and causal inference methodologies like Mendelian randomization. Burst detection analysis revealed a temporal shift from foundational concepts (e.g., "oxidative stress", "inflammation") toward interventional strategies (e.g., "fecal microbiota transplantation", "traditional Chinese medicine") and causal inference approaches (e.g., "Mendelian randomization"). Co-citation analysis highlighted seminal contributions, including clinical trials demonstrating FMT efficacy and animal studies elucidating the role of microbial metabolites such as butyrate. CONCLUSION: This study presents the inaugural bibliometric analysis of the GM-DPN research field. The domain is transitioning from establishing associative links to elucidating causal mechanisms and evaluating targeted interventions. Keyword trend analysis underscores a convergence toward a multi-mechanistic gut-brain axis model. Future research priorities derived from the literature encompass clinical translation, multi-omics integration, and personalized therapeutic strategies.