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It is more stable, longer-lasting and clinically superior to cyanocobalamin a cheaper synthetic form widely used in beauty salons and non-medical clinics that contains a small amount of cyanide which the body must detoxify

Also, the cross-over design of the study may not be most appropriate to answer the study question given that cobalamin could be stored in the liver for a long time up to 2 to 3 years

Unlike fat-soluble vitamins (A, D, E, and K) that dissolve in lipids and can be stored in body tissues for extended periods, water-soluble vitamins dissolve in water and are generally not stored in significant amounts within the body

200,201 Furthermore, mood disorders are significantly more common in diabetes patients, adversely affecting glycemic control and increasing the risk of complications