Diabetes mellitus is a growing public health concern in India and is commonly associated with long-term neurological complications. Diabetic neuropathy is one of the most frequent and disabling outcomes of the disease. While nerve fiber loss has traditionally been emphasized, recent clinical and functional evidence suggests that myelin damage plays a significant but often underrecognized role in the early stages of neuropathy. From a non-pathological perspective, diabetes-related myelin dysfunction is reflected by slowing of nerve conduction and sensory abnormalities rather than direct structural damage. This review summarizes available Indian evidence, with special reference to Chhattisgarh, to highlight the contribution of metabolic dysregulation to functional myelin impairment and its clinical relevance.
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