In DPN, hyperglycemia and oxidative stress lead to Schwann cell dysfunction and apoptosis, resulting in demyelination and impaired nerve conduction.347,348 High glucose levels inhibit the PI3K/Akt pathway in Schwann cells, leading to overexpression of DNA methyltransferases (DNMT1 and DNMT3a) and upregulation of thioredoxin-interacting protein (TXNIP). Here, TXNIP is linked to Hyperglycemia.