Diabetic neuropathy is a severe, disabling chronic condition that affects a significant number of individuals with diabetes. Long considered a disease of the peripheral nervous system, there is mounting evidence of central nervous system involvement. Recent advances in neuroimaging methods have led to a better understanding and refinement of how diabetic neuropathy affects the central nervous system. Recognition that diabetic neuropathy is, in part, a disease which affects the whole nervous system should trigger a critical rethinking of this disorder, opening a new direction for further research.