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Most probably, the observation period of six months was too short to sensitively detect worsening in visual outcomes, including GCL volume loss, also proven by a recent study in which a delayed decline in visual field and GCL volume after 12 months was seen [39]

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IGF-1 exerts its effects through the IGF-1 receptor, which activates a cascade of intracellular signaling pathways that promote cell growth and survival (Kenyon, 2010)

Recommended dosage: one strip twice daily for a minimum of three months for best results

Opioids (Tramadol and Oxycodone) considered third-line treatments for DPN, used only when previous therapies are ineffective