Objective: To identify the main metabolic and cardiovascular determinants of peripheral neuropathy in type 2 diabetics. Materials and methods: We collected 270 records of type 2 diabetic patients and compared 90 patients with peripheral neuropathy with 180 without neuropathy, and then we proceeded to a statistical analysis of the data by binary then multivariate logistic regression based on the SPSS20 software. Results: The average age of the cases is 65.5 ± 19.4 years with a sex ratio of 0.64. The majority are sedentary and obese. Tingling is the most frequent revealing symptom (86.5%) with the abolition of DTR (51.7%), Pain affected more than 83% of cases with an average score PN4 = 4.53 ± 1.61. More than 83% of PDN+ diabetics are hypertensive and ¾ suffer from proven cardiovascular disease. The risk factors for PDN are (univariate regression): android obesity [OR = 2.43], HbA1c > 7% [OR = 4.85], cardiovascular disease [OR=5.32], 24-hour micro albuminuria [OR=6.89], dysautonomic neuropathy [OR=9.72], hypertension [OR =3.49], a as well as triglyceride level > 1.50 g/L [OR =1.89]. The multivariate model retains: Glycemic imbalance, physical inactivity, and android obesity, presence of cardiovascular disease, EUA/24 hours and dysautonomic neuropathy. Conclusion: Our study confirms the multifactorial etiology of diabetic peripheral neuropathy involving essentially the interaction of metabolic, cardiovascular among the other clinical and dietetic factors.