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if there is neither efficacy nor adverse events at two weeks, it is recommended to consider increasing the dose to 100 mg/day

In accordance with the higher vulnerability of lower-limb long axons to injury, DPN usually develops first in the feet and then progresses proximally involving the upper limbs (dying-back type of axonal degeneration), and patients typically present with a stocking-glove like distribution of neuronal dysfunction (51)

How is Vitamin B12 injection given

Activation of certain conventional, novel, and atypical PKC isoforms has been shown to occur through oxidation of the kinases cysteine-rich zinc finger region, which causes release of zinc and subsequent instigation of kinase activity independently of DAG or calcium [196]