In its simplest terms, diabetic peripheral neuropathy can be defined as: " the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes." It is estimated that at least 20% of adults with diabetes have at least one manifestation of diabetic peripheral neuropathy. Diabetic neuropathy is usually characterized by a distal symmetric axonal-sensory neuropathy, usually involving first the feet and legs and then hands. Although the exact pathophysiology remains unclear, it is likely that hyperexcitable axon membranes play a role. Affected patients often complain of a spontaneous burning pain, numbness, pins and needles in the lower extremities. Sleep disruption is common, largely because the sensations of pain are exacerbated at night. A number of factors are associated with an increased risk of diabetic neuropathy, including poor sugar control, raised triglyceride levels, a high body mass index, smoking & hypertension.