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For people with type 2 diabetes, the main benefit is improved blood sugar control

Treatment of pernicious anaemia or vitamin B12 deficiency typically involves 1mg injections daily or alternate daily for 1 to 2 weeks meaning the dose is five thousand times smaller than the single dose used in cyanide poisoning, and therefore urinary discolouration is not expected to be observed

Transplant Proc 1979

It attributes the sensation to needle trauma and mast cell degranulation combined with a pH mismatch, claiming the medication sits at pH 3.5 to 4.5 against skin at 4.5 to 5.5