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Methylcobalamine and Diabetic Neuropathy
Clinical usefulness of intrathecal injection
of methylcobalamin in patients with diabetic neuropathy Ide H Fujiya S
Asanuma Y Tsuji M Sakai H Agishi Y, Clin Ther (1987) 9(2):183-92
Seven men and four women with symptomatic diabetic neuropathy were treated
with methylcobalamine (2,500 micrograms in 10 ml of saline) injected intrathecally.
Treatment was begun when patients had good metabolic control, as determined
by measurements of plasma glucose and hemoglobin, and was repeated several
times with a one-month interval between injections. Three patients were
re-treated one year after the last intrathecal injection. Symptoms in
the legs, such as paresthesia, burning pains, and heaviness, dramatically
improved. The effect appeared within a few hours to one week and lasted
from several months to four years. The mean peroneal motor-nerve conduction
velocity did not change significantly. The mean (+/- SD) concentration
of methylcobalamin in spinal fluid was 114 +/- 32 pg/ml before intrathecal
injection (n = 5) and 4,752 +/- 2,504 pg/ml one month after intrathecal
methylcobalamin treatment (n = 11). Methylcobalamine caused no side effects
with respect to subjective symptoms or characteristics of spinal fluid.
These findings suggest that a high concentration of methylcobalamin in
spinal fluid is highly effective and safe for treating the symptoms of
diabetic neuropathy.
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