Benfotiamine Versus Vitamin B1-6-12 for Diabetic Peripheral Neuropathy

Inclusion Criteria: * Age ≥18 years. * Diagnosis of diabetic peripheral neuropathy confirmed by a physician based on the following ICD-10 codes: E11.42: Type 2 diabetes mellitus with diabetic polyneuropathy; or E11: Type 2 diabetes mellitus, combined with either: M79.2: Neuralgia and neuritis, unspecified; or G62.9: Polyneuropathy, unspecified. * Presence of sensory neuropathy symptoms assessed using the Neuropathy Total Symptom Score-6 (NTSS-6), with: Total NTSS-6 score ≥1; and Numbness symptom score (NTSS-6 item 6) ≥1. * No evidence of vitamin B12 deficiency, defined as a serum vitamin B12 level ≥200 pg/mL (148 pmol/L). * provide informed consent and participate in the study. Exclusion Criteria: * Presence of fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltose malabsorption. * Adjustment of doses of medications used for neuropathic pain control within 6 weeks prior to study enrollment, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), gabapentinoids, or other neuropathic pain medications. * Presence of other conditions that may affect diabetic peripheral neuropathy or neuropathic pain, including: * Chemotherapy-induced peripheral neuropathy due to neurotoxic agents within 6 months prior to enrollment, including vinca alkaloids, taxanes, platinum-based agents, proteasome inhibitors, thalidomide, brentuximab vedotin, or ado-trastuzumab emtansine. * HIV/AIDS with any of the following: Current or previous treatment with didanosine, stavudine, or zalcitabine; CD4 count \<200 cells/mm³; or HIV viral load \>1,000 copies/mL. * Drug-induced polyneuropathy (ICD-10: G62.0). * Polyneuropathy due to other toxic agents (ICD-10: G62.2). * Alcoholic polyneuropathy (ICD-10: G62.1). * Fibromyalgia (ICD-10: M79.7). * Planned surgery within 3 months prior to or during the study period. * Previous pain-relief procedures, including: * Transcutaneous electrical nerve stimulation (TENS) or temporary peripheral nerve stimulation (PNS) within 1 year prior to enrollment; * Permanent PNS; * Pulsed radiofrequency or radiofrequency ablation within 6 months prior to enrollment; * Botulinum toxin injection for neuropathic pain relief within 12 weeks prior to enrollment. * Adjustment of glucose-lowering medication doses or HbA1c \>8% within 3 months prior to study enrollment. * Pregnancy, planned pregnancy within 3 months, or currently breastfeeding. * Inability to attend scheduled study visits in person or through telemedicine follow-up as required by the study protocol. * Known allergy or hypersensitivity to benfotiamine or any component of benfotiamine, vitamin B1, vitamin B6, or vitamin B12. * Previous use of benfotiamine and/or vitamin B1-6-12 discontinued less than 7 days before study enrollment. * Current use of vitamin B6 supplementation or medications containing vitamin B6 at a dose \>100 mg/day.