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BACKGROUND: Diabetic neuropathy is a common and troublesome microvascular complication of diabetes. It includes wide range of abnormalities involving peripheral and autonomic nerve functions. The aim of this study was to clinically evaluate various neuropathies in diabetic patients and to assess the relationship between duration of diabetes and onset of neuropathy and coexistence of peripheral neuropathy and autonomic neuropathy. METHOD: Subjects (n=50, mean age-57.6 years) with diabetes were studied. Evaluation of peripheral neuropathy was based on clinical symptoms, signs and nerve conduction study. Assessment of autonomic neuropathy was based on a battery of Ewing's cardiovascular autonomic tests. RESULTS: Diabetic polyneuropathy (76%) was the most common neuropathy detected. Numbness (80.3%) was the most common symptom with decreased sense of vibration (81.5%) being the most common sign. Loss of ankle jerk was seen in 65.7%. Autonomic neuropathy was detected in 26%. Neuropathy was more common in 5th decade of life with male preponderance. Association between disease duration and risk of diabetic neuropathy is strong. CONCLUSION: Distal symmetric polyneuropathy and autonomic neuropathy were the commonest types of neuropathy in diabetes mellitus. We suggest that all the patients with diabetes should undergo the common tests for autonomic dysfunction. The association of duration of diabetes and neuropathy was strong. Coexistence of autonomic and peripheral neuropathies was also observed.

Background: Diabetes mellitus is the fifth leading cause of death worldwide and is one of the common co-morbid conditions associated with coronary artery disease (CAD). The overall prevalence of CAD is 7.4% but the prevalence of CAD in diabetics is 9%. Hence treatment of hyperglycemia is a key goal of secondary preventive therapy with a target of reducing HbA1c to <7%. The risk of CAD has been reported to occur 2 to3 decades prior in diabetics compared to non-diabetics. Hence discovery of drugs with potential role in both diabetes and CAD seems to be necessary. Ranolazine is a novel oral anti anginal drug known to reduce HbA1c and fasting blood glucose levels in angina patients with diabetes. The objective of this study is to show the effect of ranolazine (antianginal drug) on HbA1c and fasting blood glucose levels in diabetic patients with chronic angina.Methods: Patients were divided into: Group 1 continued with previous antidiabetic drugs and antianginal drugs. Group 2 were prescribed Tab ranolazine 1000mg b.d (orally) as add on therapy along with previous antidiabetic drugs and antianginal drugs.Results: There was a significant reduction in HbA1c and FBS levels in Group 2 patients who were on ranolazine. Reduction of HbA1c in group1 and Group 2 was 0.21±0.65% and 1.30±1.16% respectively. Reduction of FBS in group1 and group2 was 10.66±27.80mg/dl and 29.97±31.49mg/dl respectively.Conclusions: From the present study we can conclude that ranolazine, an antianginal drug when given at a dose of 1000mg bd in diabetic patients with chronic angina reduces HbA1c and FBS levels.