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Several factors have been suggested to affect ROS levels in cells, including hypoxia, ER stress, metabolic alteration, and oncogenes [3]

The last enzyme in this pathway, methylmalonyl-CoA mutase, requires vitamin B12 as a cofactor in the conversion of methylmalonyl-CoA to succinyl-CoA which then enters the TCA cycle

The European Union (EU) Joint Programme-Neurodegenerative Disease Research (JPND) states that by the year 2030, a quarter (25%) of the European population will be over age 65, a significant increase over the current 16% [1]

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Therefore, using antidepressants, GABA analogs, opioids, and topical agents to treat pain in PDN is recommended

CGI-I, Clinical Global Impression Scale for Improvement