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Clinically, this manifests as progressive sensory loss (5.07 g monofilament testing) and neuropathic pain (DN4 score 4), correlating with serum 8-OHdG levels ( Hyperglycemia-induced mitochondrial dysfunction in neuronal and Schwann cells leads to excessive O 2 production at complex I and III of the ETC, which initiates a cascade of injury through four primary mechanisms (Wu L