PURPOSE: Investigate the correlation between chronic inflammatory indicators and DPN in hospitalized elderly patients with Type 2 diabetes mellitus (T2DM), and to build a prediction model to provide scientific basis for early identification of high-risk groups. PATIENTS AND METHODS: Clinical data of 270 elderly T2DM patients hospitalized in the People's Hospital of Ningxia Hui Autonomous Region from January 2021 to December 2024 were selected and classified into a diabetic peripheral neuropathy group (DPN, n=163) and a non-diabetic peripheral neuropathy group (NDPN, n=107) depending on the presence of DPN. Clinical features, biochemical indicators and peripheral blood inflammatory indicators (PLR, NLR, MLR, SII, SIRI) of patients were collected, and a predictive model was constructed by logistic regression analysis. RESULTS: The age, duration of diabetes, retinopathy, HbA1c, fasting blood glucose (FBG) and 2hPPG in DPN group were all higher than those in nonDPN group (P<0.05). In addition, the levels of PLR, NLR, MLR, SII and SIRI in DPN group were significantly higher than those in NDPN group (P<0.05). Multivariate Logistic regression analysis showed that the duration of diabetes, accompanying retinopathy, HbA1c and NLR were independent risk factors for DPN. The area under ROC curve (AUC) of the combined predictor constructed based on these factors was 0.802, which showed good prediction efficiency. CONCLUSION: Chronic inflammatory indicators such as PLR, NLR, MLR, SII and SIRI are closely related to elderly T2DM patients with DPN. Comprehensive evaluation of these indicators and key factors such as diabetes course can effectively predict the risk of elderly T2DM patients with DPN, which is conducive to early intervention and management, thereby improving patient prognosis. Reduce hospitalization rates and medical costs. This study provides a new perspective for understanding the role of chronic inflammation in DPN and lays the foundation for further research.