DM leads to various complications which can be divided into microvascular (retinopathy, neuropathy, and nephropathy) and macrovascular (coronary artery disease, cerebrovascular disease, and peripheral arterial disease).

Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of DM. Previous studies have shown that 26.4% of type 2 DM patients are complicated by painful DPN , while up to 50% of the DPN patients may be asymptomatic .

Diabetic peripheral neuropathy is defined as the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes (3).

Chronic inflammatory process has been shown to play a central role in DPN . Neutrophil-to-lymphocyte ratio (NLR) is a novel and inexpensive marker to reflect many kinds of inflammatory states including diabetes and its microvascular complications.

Diagnosing DPN depends on clinical examination and Nerve Conduction Study (NCS) but only large myelinated nerve fibers injury can be detected by traditional electrophysiological methods. However, development of DPN involves different diameters of peripheral, sensory and motor nerve fibers which creates difficulties for early detection and diagnosis of DPN. Thus, searching for a reliable indicator for early diagnosis is very important.

Studies are lacking which can show consistent relation between NLR and DPN thus, through this study we aim to assess and compare the NLR in type 2 DM patients with and without DPN.