الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
Diabetic peripheral neuropathy is a leading cause for disability due to foot ulceration and amputation, gait disturbance and fall-related injuries.About 60% to 70% of all people with diabetes will eventually develop peripheral neuropathy, although not all suffer pain.
Diabetic peripheral neuropathy represents an ongoing therapeutic challenge for patients and caregivers and it is thought that many cases may be difficult to be treated .Some authors believe that despite strict blood glucose control, nerve damage may be inevitable.
WHO now estimates that globally one billion people have vitamin D deficiency or insufficiency. Low vitamin D status is thought to be associated with the development of type-2 diabetes as well as metabolic syndrome. Vitamin D insufficiency correlates positively with insulin resistance and that 25-OH vitamin D supplementation improves insulin resistance.
The aim of this work was to study the possible relation between vitamin D deficiency and diabetic peripheral neuropathy patients in Beni-Suefgovernorate, north Upper Egypt.
This study is a case control study and was conducted in department of neu¬rology, Beni-Suef university hospital during the period between December 2016 and September 2017. The study included 25 diabetic peripheral neuropathy patients and 25 healthy controls
All patients were subjected to:
1. Detailed History taking: focusing on duration of Diabetes Mellitus, neuropathy symptoms and other microvascular complications of Diabetes Mellitus.
2. Thorough neurological examination according to the neurology sheet currently used in neurology departmentBeni-SuefUniversity hospital.
3. MichiganNeuropathyScreeningInstrument.
4. Nerve Conduction Study
5. Laboratoryinvestigations includes: .
A-Fasting and 2 hours post prandialtest.
B-HemoglobinA1Ctest .
C-Vitamin D assay.
The results of this work can be summarized in these points:
Vitamin D deficiency was high prevalent in diabetic peripheral neuropathy patients compared to controls P-value 0.008.
Vitamin D deficiency was also more prevalent in diabetic neuropathy female patients compared to males P-value 0.003. However, Severity of neuropathy was similar in both males and females P-value 0.46.
There was no significant difference between patients below and above the age of 50 years regarding Michigan neuropathy screening instrument and Vitamin D level P value (0.916 and 0.525) respectively.
Two of our patients had normal vitamin D level, 7 patients had insufficiency and 16 patients had deficiency.
Diabetic peripheral neuropathy patients with Michigan neuropathy screening instrumentscore more than 4 had statistically significant lower vitamin D level (P value 0.006).
Serum Vitamin D level and MNSI showed insignificant difference between diabetic neuropathy patients with duration of Diabetes less and more than 5years P-value 0.7 and 0.124 respectively.
Despite serum vitamin D level was not related to type of treatment of diabetes, neuropathy was observed to be more severe in diabetes mellitus patients who currently receive insulin alone P-value 0.038.
Insignificant difference was found between fair and poor control Diabetes mellitus patients regarding Vitamin D level and Michigan neuropathy screening instrumentscore (P value 0.252 and 0.325) respectively.
Nerve conduction study results were not affected by serum vitamin D level. Sural nerve amplitude was significantly affected by poor glycemic control. Michigan neuropathy screening instrument was correlated positively with Median nerve latency and negatively with Peroneal motor velocity, amplitude and sural nerve velocity.