Department of Neurology, Beijing Hangtian Central Hospital, Beijing   100049, China

Jilai Li, Attending physician, Department of Neurology, Beijing Hangtian Central Hospital, Beijing   100049, China Li JL, Wan ZR. Prostaglandin E1 in conjunction with high doses of vitamin B12 improves nerve conduction velocity of patients with diabetic peripheral neuropathy. Neural Regen Res 2008;3(5):529-32

Abstract

BACKGROUND: Prostaglandin E₁ improves diabetic peripheral neuropathy  in symptoms and sensory threshold. Vitamin B₁ and methyl-vitamin B₁₂ improve microcirculation to peripheral nerve tissue and promote neurotrophy.

OBJECTIVE: To observe motor nerve and sensory nerve conduction velocity in patients with diabetic peripheral neuropathy, prior to and after treatment with prostaglandin E₁, vitamin B₁ and different doses of vitamin B₁₂.

DESIGN, TIME AND SETTING: Randomized, controlled experiment, performed at the Department of Neurology, Beijing Hantian Central Hospital, between February 2002 and September 2007.

PARTICIPANTS: A total of 122 patients with type 2 diabetic peripheral neuropathy; 73 males and 49 females were included. All patients met the diagnostic criteria of diabetes mellitus, as determined by the World Health Organization in 1999 and 2006, and also the diagnostic criteria of diabetic peripheral neuropathy. For each subject, conduction disorders in the median nerve and in the common peroneal nerve were observed using electromyogram. Also, after diet and drug treatment, the blood glucose level of subjects was observed to be at a satisfactory level for more than two weeks, and the symptoms of diabetic peripheral neuropathy were not alleviated.

METHODS: All patients were randomly divided into the following three groups. A control group (n = 40), in which, 100 mg vitamin B₁ and 500 μg vitamin B₁₂ were intramuscularly injected. A vitamin B₁₂ low-dose treated group ( n = 42), in which 10 μg prostaglandin E₁ in 250 mL physiological saline was intravenously injected once a day and 100 mg vitamin B₁ and 500 μg vitamin B₁₂ was intramuscularly injected once a day. Lastly, a vitamin B₁₂ high-dose treated group (n = 40), in which administration was the same as in the vitamin B₁₂ low-dose treated group, except that 500 μg vitamin B₁₂ was replaced by 1 mg vitamin B₁₂. Administration was performed for four weeks for each group.

MAIN OUTCOME MEASURES: The motor nerve and sensory nerve conduction velocity of the median nerve and the common peroneal nerve were determined using an electromyogram electronic stimulator (Neuropack-II, Nihon Kohden, Japan).

RESULTS: The motor nerve and sensory nerve conduction velocities of the median nerve and the common peroneal nerve were significantly faster after treatment compared to before treatment in all 3 groups (P < 0.05–0.01). Compared with the control group, the motor nerve and sensory nerve conduction velocities were significantly faster in the vitamin B₁₂ low-dose treated group and in the vitamin B₁₂ high-dose treated group (P < 0.01). The motor nerve and sensory nerve conduction velocities were significantly faster in the vitamin B₁₂ high-dose treated group compared to the vitamin B₁₂ low-dose treated group (P < 0.05).

CONCLUSION: Prostaglandin E₁, in conjunction with vitamin B₁₂, can improve neural functional states and speed up peripheral motor nerve and sensory nerve conduction velocity in diabetic peripheral neuropathy. In addition, better effects are achieved using prostaglandin E₁ in conjunction with high doses of vitamin B₁₂.

Key Words: prostaglandin E₁; vitamin B₁₂; diabetes mellitus; diabetic peripheral neuropathy

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