Diabetic Peripheral Neuropathy  (DPN) is the most common complication of Diabetes Mellitus (DM) with a lifetime prevalence of about 50%. The prevalence of peripheral neuropathy in individuals with diabetes mellitus depends on the duration of the disease;  clinically, and up to 80% of those who have had the disease for more than 15 years.  Diabetic peripheral neuropathy in type 2 diabetes mellitus may affect the all part of the nervous  system but  most affected is symmetric neuropathy in which segmental demyelination, schwann cell injury, and axonal damage,that involves distal sensory and motor nerves. Individuals with the neuropathy develop decreased sensation in the distal extremities with less evident motor abnormalities. The loss of pain sensation can result in the development of ulcers, which heal poorly because of the diffuse vascular injury in diabetes and are a major cause of morbidity.The pathogenesis of neuropathy is unknown  but it may be due to accumulation of sorbitol and fructose as a result of hyperglycaemia, leading to deficiency of myoinositol . The condition is significantly associated with age, duration of disease, daistolic blood pressure, smokers, low HDL cholesterol level and high LDL level and HBA1C .

pathological feature include axonal Several types of polyneuropathies are seen in long-standing and poorly-controlled cases of DM. of both myelinated and unmyelinated fibres. With the thickening of Schwann cell basal lamina. Patchy segmental demyelination and abnormal intraneural capillaries, ( with basement membrane thickening and microthrombi) . Diabetic neuropathic pain is characterised by  tingling, burning, sharp , shootingand lacinating or even as electrical shock sensations. These Features are also seen in of kidrTreatment of peripheral neuropathies should focus on the treatment of the underlying disease process. For example, glucose control in diabetic neuropathies can be with membrane stabilizers, certain anti-epileptics, and tricyclic antidepressants.FDA has approved 3 medications for the pain with DPN (Pregablin, Duloxetine, Tapentadol) but none affords complete relief