الفهرس 
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Abstract
Background: Diabetes mellitus (DM) is proving to be a global public health burden as this number is expected to increase to another 200 million by 2040. Despite the different etiologies of type 1 and type 2 diabetes, both are associated with a number of complications affecting the cardiovascular system, kidneys, eyes and nerves. Damage to the macrovascular system originally leads to different complications as cardiovascular disorders, heart failure, atherosclerosis and cerebrovascular events. The other key complications have been long known as ‘microvascular’ injuries and manifest as diabetic kidney disease, diabetic retinopathy and diabetic neuropathy. Most of the morbidity and mortality risks associated with diabetes results from these complications. Diabetes mellitus is a well-known cardiovascular risk factor in developed countries. In the Framingham study the rate of occurrence of cardiovascular disease in diabetic men was two folds higher that among non-diabetic men, and similarly was three folds more elevated in diabetic women compared to non-diabetic women. Diabetic peripheral neuropathy (DPN) is a popular, incapacitating, and distressing complication that occurs in nearly 30–50% of patients with diabetes. Most diabetic patients develops painless distal bilaterally equal sensorimotor neuropathy, that raises the risk developing foot ulcers and finally leading to amputation.The mechanisms linking microvascular and macrovascular complications in diabetic patients are emerging. Macrovascular and microvascular complications can be explained by increased vascular wall permeability and leakage due to generalized vascular dysfunction. This process finally causes nephropathy or retinopathy in small arteriolar or capillary beds and facilitating entry or accumulation of lipids in large arteries causing atherosclerosis. Patients and Methods : The study was conducted on 118 type 2 diabetic patients (both males and females). The patients were divided into 2 groups: • 66 patients with cardiac ischemia on coronary angiography. This group was divided into 3 groups according to Gensini score : Mild ischemia: Gensini score < 20. Moderate ischemia: Gensini score = 20 - 48. Severe ischemia: Gensini score > 48. • 52 patients with normal coronary angiography. Results : Diabetic polyneuropathy (NDS≥ 6), abnormal NCS, CTS, ES, axonal neuropathy were all higher in the group with abnormal coronary angiography. Proportion of UL lesions were higher in the group with normal coronary angiography while LL and combined upper & lower limb lesions were higher in the group with abnormal coronary angiography. Conclusion: The conclusion from our study is that there is a strong association between coronary artery diseases and diabetic peripheral neuropathy and its severity. So, DPN can be used as a predictor of myocardial ischemia in clinical practice especially silent myocardial ischemia to limit the exposure to unnecessary coronary angiography.