Neurological Movement Disorders in Diabetes Mellitus: A Narrative Review

Diabetes mellitus is increasingly recognized as a systemic disorder with diverse neurological manifestations extending beyond peripheral neuropathy and cerebrovascular disease. Among these, movement disorders represent an underappreciated but clinically significant complication arising from metabolic dysregulation, microvascular injury, neuroinflammation, and neurotransmitter imbalance affecting central motor pathways. This narrative review summarizes the spectrum of movement disorders associated with diabetes mellitus, including chorea–hemiballismus, parkinsonism, tremor, dystonia, myoclonus, ataxia, and sleep-related movement disorders. Key pathophysiological mechanisms, characteristic neuroimaging findings, diagnostic considerations, and management strategies are discussed, with emphasis on the potential reversibility of symptoms following timely glycemic optimization. Special attention is given to prognostic factors and vulnerable populations, such as elderly patients and those with long-standing disease. This narrative review was based on a structured literature search of the PubMed, Scopus, and Google Scholar databases, covering publications from 2000 to 2025, using combinations of keywords related to diabetes mellitus and movement disorders, with additional manual screening of reference lists. Improved awareness and early interdisciplinary management are essential to optimize neurological and functional outcomes in patients with diabetes-related movement disorders.