الفهرس 
INTRODUCTION
DIABETES MELLITUSOnly 14 pages are availabe for public view
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Abstract
Diabetes is a growing public health concern and a chronic metabolic disease worldwide. It is one of the most common non-communicable diseases in the world. It falls within 4th–5th leading cause of death in most developed countries , death risk among people with diabetes is twice as that of people of the same age who do not have.
Diabetic complications can be classified into acute and chronic complications. Long term Complications from diabetes can be categorized as microvascular or macrovascular. Diabetic neuropathy is one of the chronic microvascular complications of diabetes mellitus which affects the somatic and autonomic component of the peripheral nervous system. DPN is the most common complication in patients with diabetes. It is a cause of considerable morbidity, including foot ulceration, neuropathic pain and it is the leading cause of non traumatic limb amputation. Also it is associated with cardiovascular disease and increased mortality.
Different mechanisms were described for the pathogenesis of DPN, but the exact pathogenesis of diabetic neuropathy remains unknown. Nerve damage in DPN is multifactorial, but hyperglycemia and impaired nerve regeneration are the main triggering factors. Loss of nerve fibres and Wallerian-type degeneration are the major pathological finding in diabetic neuropathic nerve.
Considering the rapid increase in number of patients with DPN and the tremendous and growing public health burden of diabetes, the development and clinical Implementation of effective and safe interventions is critical need.
Vitamin B complex consists of eight water soluble vitamins that are necessary for health but cannot be manufactured by the body. The B vitamins serve a wide variety of important functions such as, energy production and maintenance of immune and nervous system. Vitamin B12 plays vital role in the metabolism of fatty acids essential for the maintenance of nerve myelin. Prolonged vitamin B12 deficiency can lead to nerve degeneration and irreversible neurological damage. While the indication for some members of vitamin B complex for certain conditions such as thiamin for treatment of Wernik᾽s encephalopathy and folic acid for folic acid deficiency anemia are well established, their role in treatment of peripheral neuropathies hasn’t been well established
B-complex vitamins have been associated with diabetic neuropathy from both causative and curative perspectives. B-complex vitamins have been associated with diabetic neuropathy from both causative and curative perspectives. The diabetes drug metformin may induce peripheral neuropathy by causing vitamin B-12 deficiency. Diabetic neuropathy, with or without B12 deficiency, had been treated with neurotropic vitamins such as vitamin B1, B6, B9 and Vitamin B12.
Several studies have shown efficacy of B vitamins in treating peripheral neuropathy, including painful diabetic neuropathy, being a therapeutic option based on a pathogenetic concept. Because of the variations in the B vitamin combination, dose, route and duration of treatment, the active components of B vitamins cocktails remain unclear. This necissates to study histological changes reviewed in the literature in diabetic neuropathy and reviewing histological work done to study its improvement under the influence of vitamin b complex.