Emerging role of thiamine therapy for prevention and treatment of early-stage diabetic nephropathy.

Abstract

Thiamine supplementation may prevent and reverse early-stage diabetic nephropathy. This probably occurs by correcting diabetes-linked increased clearance of thiamine, maintaining activity and expression of thiamine pyrophosphate-dependent enzymes that help counter the adverse effects of high glucose concentrations-particularly transketolase. Evidence from experimental and clinical studies suggests that metabolism and clearance of thiamine is disturbed in diabetes leading to tissue-specific thiamine deficiency in the kidney and other sites of development of vascular complications. Thiamine supplementation prevented the development of early-stage nephropathy in diabetic rats and reversed increased urinary albumin excretion in patients with type 2 diabetes and microalbuminuria in two recent clinical trials. The thiamine monophosphate prodrug, Benfotiamine, whilst preventing early-stage development of diabetic nephropathy experimentally, has failed to produce similar clinical effect. The probable explanations for this are discussed. Further definitive trials for prevention of progression of early-stage diabetic nephropathy by thiamine are now required.

• Authors: N Rabbani, P J Thornalley
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 13 Issue 7 Pg. 577-83 (Jul 2011) ISSN: 1463-1326 [Electronic] England
• PMID: 21342411 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: © 2011 Blackwell Publishing Ltd.

Chemical References

• Thiamine

Topics

• Albuminuria (complications, prevention & control)
• Animals
• Diabetes Mellitus, Experimental (complications, drug therapy)
• Diabetes Mellitus, Type 2 (complications, drug therapy, prevention & control)
• Diabetic Nephropathies (drug therapy, prevention & control)
• Dietary Supplements
• Humans
• Rats
• Thiamine (pharmacokinetics, therapeutic use)