What is diabetes mellitus, at least we know well, but we are not realising the consequence of this disease. The diabetes mellitus - commonly known as “Sugar” - is now an uncontrolled. It is a devil divesting not only the old population but also badly affecting our young generations.

There are approximately 7.1 million diabetic patients in Pakistan, and it is projected to have 11.4 million diabetics and rank 10th in the world in 2030.

Diabetes is a chronic, lifelong condition that affects your body's ability to use the energy found in food. There are three major types of diabetes: type 1, type 2, and gestational diabetes. All types of diabetes mellitus have something in common.

Normally, our body breaks down the sugars and carbohydrates we eat into a special sugar called glucose. Glucose is an essential fuel for our body. But for utilisation of energy, cells need insulin, a hormone, in our bloodstream. Since the cells can't take in the glucose, it builds up in your blood. Instead persistent high levels of blood glucose are detrimental for body and can damage the tiny blood vessels in your kidneys, heart, eyes, or nervous system. That's why diabetes - especially if left untreated - can eventually cause heart disease, stroke, kidney disease, blindness, and nerve damage to nerves in the feet.

The first symptoms are related to the direct effects of high blood glucose levels. When this level rises above 160 to 180 mg/dL, glucose spills into the urine. When the level of glucose in the urine rises even higher, the kidneys excrete additional water to dilute the large amount of glucose. Because the kidneys produce excessive urine, people with diabetes urinate in large volumes frequently. Because excessive calories are lost in the urine, people may lose weight.

If this disease remained untreated, it develops into “Diabetic Neuropathy” affecting as many as 50% of patients with diabetes. Neuropathy is damage to nerves, and diabetic neuropathy is damage to nerves due to diabetes. Diabetes is thought to damage nerves as a result of prolonged elevated levels of blood glucose.

Diabetic neuropathy can affect different parts of the body, and symptoms can range from mild to severe. Diabetic peripheral neuropathy involves the presence of symptoms or signs of peripheral nerve dysfunction in people with diabetes after other possible causes have been excluded.

In type 1 diabetes mellitus, distal polyneuropathy typically becomes symptomatic after many years of chronic prolonged hyperglycemia. Conversely, patients with type 2 diabetes mellitus may present with distal polyneuropathy after only a few years of known poor glycemic control; sometimes, these patients already have neuropathy at the time of diagnosis.

Neuropathies severely decrease patients' quality of life (QOL). Furthermore, while the primary symptoms of neuropathy can be highly unpleasant, the secondary complications (e.g. falls, foot ulcers, cardiac arrhythmias, and ileus) are even more serious and can lead to fractures, amputations, and even death in patient.

A recent study in our department demonstrated that about 33% of diabetic patients are suffering from diabetic neuropathy. The study also revealed that obesity, smoking, elevated level of fats in blood and age are important risk factor for this ailment. Therefore, older people are more frequently affected with neuropathy.

The management of diabetic neuropathy includes two approaches: therapies for symptomatic relief and those that may slow the progression of neuropathy. Of all treatments, tight and stable glycemic control is probably the most important for slowing the progression of neuropathy. Many medications are available for the treatment of diabetic neuropathic pains.

Ginkgo biloba, a Chinese herb, has been used medicinally for thousands of years. Today, it is one of the top-selling herbs in the United States.

Ginkgo biloba is used for the treatment of numerous conditions, many of which are under scientific investigation. The only source of ginkgo is the ginkgo tree. Most ginkgo supplements are derived from the leaves.

Ginkgo biloba is an herbal remedy that may be beneficial in treating both your poor circulation and neuropathy. Ginkgo is well-known for its ability to boost blood flow to your head and limbs.

Ginkgo biloba is an antioxidant herb that increases blood flow to the tiny capillaries throughout the body, improving oxygen and nutrient delivery to areas affected by both diabetic neuropathy and retinopathy. This herb was used in diabetic patients and the results are remarkable.

In one research study in Lahore, we found that continuous treatment of diabetic patients with Ginkgo biloba not only reduced the intensity of pain, but also alleviated the signs/symptoms resulting in the improvement of quality of life of patients. Therefore, there is dire need to aware the population about this disease and there is a possibility of use of this herb for the management of diabetic neuropathy.

The writer is Head of Neurology Department of Services Hospital Lahore.