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document HbA1c target and achieved level Symptomatic pain management: pregabalin, gabapentin, duloxetine (FDA-approved for DPN), TCAs Foot care: preventive podiatry, custom diabetic footwear (HCPCS A5500A5513), monofilament testing Cardiovascular autonomic: fludrocortisone, midodrine for orthostatic hypotension

NNMT is a cytosolic S-adenosyl-L-methionine-dependent methyltransferase that converts nicotinamide to 1-methylnicotinamide, spending SAM and diverting nicotinamide away from the NAD+ salvage pathway

This is unlike those who did not take vitamin supplements where fortification with folic acid was, as expected, associated with lower serum tHcy concentrations than at baseline

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