Vitamin B Supplementation for Diabetic Peripheral Neuropathy: A Review and Meta-Analysis

Area of Science:

• Neurology
• Endocrinology
• Nutritional Science

Background:

• Diabetic peripheral neuropathy (DPN) is a common, disabling diabetes complication.
• B vitamins are crucial for neuronal metabolism, but their therapeutic role in DPN is debated.
• Evidence for vitamin B efficacy in DPN requires synthesis and evaluation.

Purpose of the Study:

• To evaluate vitamin B supplementation effects on clinical and neurophysiological outcomes in DPN.
• To synthesize evidence from randomized controlled trials (RCTs) on vitamin B for DPN.
• To assess the impact on pain, neuropathy scores, and nerve conduction parameters.

Main Methods:

• Systematic literature search of PubMed, Cochrane, and ClinicalTrials.gov.
• Inclusion of RCTs comparing vitamin B (any form) versus placebo/standard care in DPN patients.
• Meta-analysis of primary outcomes: pain intensity, neuropathy scores (MNSIQ, MNSIE), and nerve conduction (NCV, amplitude).

Main Results:

• Thirteen RCTs (834 participants) analyzed; vitamin B improved MNSIQ scores.
• Significant improvements in sural nerve conduction velocity and amplitude observed.
• Inconsistent effects on pain intensity and motor nerve parameters; combination therapy showed potential.

Conclusions:

• Vitamin B supplementation may offer benefits for specific DPN clinical scores and sensory nerve function.
• Combination B-vitamin regimens appear more effective than monotherapy, though not statistically significant across all measures.
• Heterogeneity and risk of bias limit recommendations; further RCTs stratified by vitamin status are needed.