THE USE OF VITAMIN B_12 IN THE MANAGEMENT OF THE NEUROLOGIC MANIFESTATIONS OF DIABETES MELLITUS, WITH NOTES ON THE ADMINISTRATION OF MASSIVE DOSES

Abstract

Of 12 patients with diabetic "neuropathy" who were given crystalline vit. B12 parenterally for 1-12 mos., 5 had had poor control of their diabetes prior to treatment and 7 had been observed for months or years previously and had been well managed, but had developed neurologic manifestations in spite of such management. Four patients showed a complete neurologic remission, 3 an almost complete remission, 3 were improved, and 2 were questionably improved. The initial effective dosage was 15-30 [mu]g. daily for 7 to 14 days, and the maintenance therapy was 15-30 [mu]g. once or twice weekly. Massive doses of 1000 [mu]g. should be reserved for use in patients refractory to smaller doses; they do not produce a cumulative effect lasting longer than the smaller amounts. The 2-fold nature of diabetic "neuropathy," i.e., vascular and metabolic, may be responsible for the variable results of therapy in individual patients.