Effectiveness of vitamin B12 on diabetic neuropathy: systematic review of clinical controlled trials - Alternative Medicine for Diabetic Neuropathy

Author's objectives
To assess the effectiveness of vitamin B12 supplements for the treatment of diabetic neuropathy.

Author's conclusions
Among patients with diabetic neuropathy, treatment with both combination agents (vitamin B complex with cyanocobalamin) and pure methylcobalamin appeared to improve symptomatic relief more than electrophysiologic results.

Bibliographic details
Sun Y, Lai M S, Lu C J. Effectiveness of vitamin B12 on diabetic neuropathy: systematic review of clinical controlled trials. Acta Neurologica Taiwanica, 2005; 14(2): 48-54

Status
This record is a structured abstract written by CRD reviewers. The original has met a set of quality criteria.

CRD commentary

The review question was clearly defined in terms of the interventions, participants, outcomes and study designs. Only two databases were searched for relevant studies, and no efforts were made to identify unpublished studies. This means that some potentially relevant studies might have been missed. Efforts were made to minimise reviewer bias and errors in the study inclusion, data extraction and quality assessment processes. Validity was assessed using established criteria, but there was no assessment of the validity of methods used to assess the outcomes.

Adequate details of the studies were presented in tabular format. The narrative synthesis of the studies was appropriate given the differences between them. However, the authors classified some studies as showing positive results when there was an improvement from baseline, rather than an improvement in comparison with the control treatment; this can exaggerate the strength of the evidence. Some differences between the studies were discussed with respect to differences in the interventions and outcomes assessed. The authors appropriately highlighted the poor quality of the evidence base and the need for further research. Given the limited evidence from generally poor-quality, small studies, the authors' conclusions should be viewed as tentative until they are confirmed by further high-quality RCTs.

Publication Date: 31 May 2006
Complementary and Alternative Medicine (CAM) Specialist Library