In the 21st century, diabetes became a tread of health issue. The predominance of this disease become double in this century. It has been expected that more than 366 million people will be globally affected by diabetes. Both lifestyle and genetic factors mainly influence diabetes incidence. Insulin insensitivity is main pathophysiology of diabetes, which may occur due to insulin resistance, decreased insulin synthesis and / or pancreatic beta cell damage.
Diabetic neuropathy is a common peripheral nervous system dysfunction associated with diabetes. Almost 50% of diabetic affected individuals have complained of Diabetic neuropathy. Without treatment and care, Diabetic neuropathy can be a chronic and progressive condition. Initially, the sensory symptom appears in the toes and gradually it spreads to the upper limbs. A range of sensory symptoms such as insensitivity, pricking sensation of pins or needles, tingling, burning, electric shocks like feeling, some patients complaint loss of pain sensation, whereas others may have increased sensitivity to pain are included in diabetic neuropathy. These symptoms alter depending upon the type of nerve damages. Painful diabetic neuropathy poorly affects the quality of life of the patient. It decreases physical activity and movement increases fatigue, severe pain also causes sleep disturbance and these negatively affect social life. Metformin is widely used anti-diabetic medicine, which can accumulate in the body. Prolong consumption of this medicine leads to vitamin B12 deficiency and considered as one of the most common causes of Diabetic neuropathy.