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Diabetic Peripheral Neuropathy

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Globally, The number of patients with diabetes is increasing rapidly. By the year 2035, the number of people with diabetes worldwide is expected to rise to 592 million (IDF ATLAS 20131). Diabetic peripheral neuropathy (DPN) is a common microvascular complication of diabetes and a leading cause to amputations in hospitals (Boulton 20052). The prevalence of DPN is estimated to be 50-60% (Sandireddy R 20143). The pain associated with DPN can affect the patient quality of life (QOL). It affects their sleep, lifestyle, work and even can cause or be associated with depression (Jensen MP 20074). It is not well understood whether the mechanism behind peripheral neuropathy with diabetes is hyperglycemia or other insulting pathophysiological mechanism like proinflamatory immune mediators (Herder C 20135, Goh S-Y 20086). One of the possible mechanisms is the demyelination of the small C fiber, this is the leading cause behind the pain sensation with …show more content…

Prevention and slowing the progression of DPN via glucose control has been demonstrated to be effective in patients with type 1 diabetes, but may not be as effective in patients with type 2 diabetes (Callaghan BC 201211). Other studies found no correlation between glycated hemoglobin (HbA1C) with mean of 6.9% and the severity of DPN (Owolabi MO 201212). Diabetic patients are more susceptible to dyslipidemia and metabolic syndrome. Those patients have body mass index (BMI) ≥30Kg/m2, abnormal glucose metabolism with insulin resistance, high low-density-lipoprotein (LDL), total cholesterol (TC), triglycerides (TG), and low high-density lipoprotein (HDL). Those abnormal findings expose patients to atherosclerotic changes and microvascular complications together with hypertension and cardiovascular diseases (Mooradian AD

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