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Key points No currently available oral or topical therapy is effective as a monotherapy, but some have shown encouraging results as a part of combination therapy

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Diabetic hyperglycemia further exacerbates this by suppressing astrocytic pentose phosphate pathway flux, which depletes nicotinamide adenine dinucleotide phosphate (NADPH) reserves [132, 133], a mechanism that mirrors defects in diabetic neuropathy where impaired redox defense amplifies oxidative injury