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

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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.

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