Ozone Therapy in Patients With Diabetic Neuropathy

Inclusion Criteria: * Sixty adult diabetic patients (type II DM) * clinically symptomatized painful neuropathy for six or more months. Exclusion Criteria: * Patients with other causes of neuropathy (e.g., vitamin B12 deficiency), hereditary neuropathies and entrapment neuropathies, overt neuropathy with foot ulcers and/or amputation, peripheral vascular diseases, vertebral pathologies (e.g., previous surgery, foraminal stenosis, spinal canal stenosis, and/or vertebral disc herniation) * Patients with other medical conditions such as connective tissue diseases, thyroid disorders, significant renal or hepatic dysfunction, platelet dysfunction syndrome, critical thrombocytopenia, hemodynamic instability and septicemia * local infection at the site of the procedure * Consistent use of nonsteroidal anti-inflammatory drugs within the last two weeks * Systemic corticosteroid administration or local injection at the suspected treatment site within the last month * Recent fever or illness, hemoglobin level \<10 g/dL, platelet count \<105 \_ 109/L, and/or tobacco use.