High-dose thiamine therapy for patients with type 2 diabetes and microalbuminuria: a randomised, double-blind placebo-controlled pilot study
Aims/hypothesis High-dose supplements of thiamine prevent the development of microalbuminuria in experimental diabetes. The aim of this pilot study was to assess whether oral supplements of thiamine could reverse microalbuminuria in patients with type 2 diabetes. Methods Type 2 diabetic patients (21...
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| Veröffentlicht in: | Diabetologia 2009-02, Vol.52 (2), p.208-212 |
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| creator | Rabbani, N Alam, S. S Riaz, S Larkin, J. R Akhtar, M. W Shafi, T Thornalley, P. J |
| description | Aims/hypothesis High-dose supplements of thiamine prevent the development of microalbuminuria in experimental diabetes. The aim of this pilot study was to assess whether oral supplements of thiamine could reverse microalbuminuria in patients with type 2 diabetes. Methods Type 2 diabetic patients (21 male, 19 female) with microalbuminuria were recruited at the Diabetes Clinic, Sheikh Zayed Hospital, Lahore, Pakistan, and randomised to placebo and treatment arms. Randomisation was by central office in sequentially numbered opaque, sealed envelopes. Participants, caregivers and those assessing the outcomes were blinded to group assignment. Patients were given 3 x 100 mg capsules of thiamine or placebo per day for 3 months with a 2 month follow-up washout period. The primary endpoint was change in urinary albumin excretion (UAE). Other markers of renal and vascular dysfunction and plasma concentrations of thiamine were determined. Results UAE was decreased in patients receiving thiamine therapy for 3 months with respect to baseline (median -17.7 mg/24 h; p < 0.001, n = 20). There was no significant decrease in UAE in patients receiving placebo after 3 months of therapy (n = 20). UAE was significantly lower in patients who had received thiamine therapy compared with those who had received placebo (30.1 vs 35.5 mg/24 h, p < 0.01) but not at baseline. UAE continued to decrease in the 2 month washout period in both groups, but not significantly. There was no effect of thiamine treatment on glycaemic control, dyslipidaemia or BP. There were no adverse effects of therapy. Conclusions/interpretation In this pilot study, high-dose thiamine therapy produced a regression of UAE in type 2 diabetic patients with microalbuminuria. Thiamine supplements at high dose may provide improved therapy for early-stage diabetic nephropathy. Trial registration: CTRI (India) CTRI/2008/091/000112 Funding: Pakistan Higher Education Commission |
| doi_str_mv | 10.1007/s00125-008-1224-4 |
| format | Article |
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S ; Riaz, S ; Larkin, J. R ; Akhtar, M. W ; Shafi, T ; Thornalley, P. J</creator><creatorcontrib>Rabbani, N ; Alam, S. S ; Riaz, S ; Larkin, J. R ; Akhtar, M. W ; Shafi, T ; Thornalley, P. J</creatorcontrib><description>Aims/hypothesis High-dose supplements of thiamine prevent the development of microalbuminuria in experimental diabetes. The aim of this pilot study was to assess whether oral supplements of thiamine could reverse microalbuminuria in patients with type 2 diabetes. Methods Type 2 diabetic patients (21 male, 19 female) with microalbuminuria were recruited at the Diabetes Clinic, Sheikh Zayed Hospital, Lahore, Pakistan, and randomised to placebo and treatment arms. Randomisation was by central office in sequentially numbered opaque, sealed envelopes. Participants, caregivers and those assessing the outcomes were blinded to group assignment. Patients were given 3 x 100 mg capsules of thiamine or placebo per day for 3 months with a 2 month follow-up washout period. The primary endpoint was change in urinary albumin excretion (UAE). Other markers of renal and vascular dysfunction and plasma concentrations of thiamine were determined. Results UAE was decreased in patients receiving thiamine therapy for 3 months with respect to baseline (median -17.7 mg/24 h; p < 0.001, n = 20). There was no significant decrease in UAE in patients receiving placebo after 3 months of therapy (n = 20). UAE was significantly lower in patients who had received thiamine therapy compared with those who had received placebo (30.1 vs 35.5 mg/24 h, p < 0.01) but not at baseline. UAE continued to decrease in the 2 month washout period in both groups, but not significantly. There was no effect of thiamine treatment on glycaemic control, dyslipidaemia or BP. There were no adverse effects of therapy. Conclusions/interpretation In this pilot study, high-dose thiamine therapy produced a regression of UAE in type 2 diabetic patients with microalbuminuria. Thiamine supplements at high dose may provide improved therapy for early-stage diabetic nephropathy. Trial registration: CTRI (India) CTRI/2008/091/000112 Funding: Pakistan Higher Education Commission</description><identifier>ISSN: 0012-186X</identifier><identifier>EISSN: 1432-0428</identifier><identifier>DOI: 10.1007/s00125-008-1224-4</identifier><identifier>PMID: 19057893</identifier><language>eng</language><publisher>Berlin/Heidelberg: Berlin/Heidelberg : Springer-Verlag</publisher><subject>Albuminuria - prevention & control ; Associated diseases and complications ; Biological and medical sciences ; Blood Pressure ; Diabetes ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - urine ; Diabetes. Impaired glucose tolerance ; Diabetic complications ; Diabetic nephropathy ; Double-Blind Method ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Glomerular Filtration Rate ; Glycated Hemoglobin A - metabolism ; Human Physiology ; Humans ; Internal Medicine ; Kidneys ; Lipids - blood ; Medical sciences ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Microalbuminuria ; Nephrology. Urinary tract diseases ; noninsulin-dependent diabetes mellitus ; Patients ; Pilot Projects ; Placebos ; Plasma ; Short Communication ; thiamin ; Thiamine - blood ; Thiamine - therapeutic use ; Thiamine - urine ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract. Prostate gland ; Vitamin B</subject><ispartof>Diabetologia, 2009-02, Vol.52 (2), p.208-212</ispartof><rights>Springer-Verlag 2008</rights><rights>2009 INIST-CNRS</rights><rights>Springer-Verlag 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-2c42ec0b9e3dc884220dba7d6d4fcffa899d3099479f7862774cfa85fe2d61cd3</citedby><cites>FETCH-LOGICAL-c466t-2c42ec0b9e3dc884220dba7d6d4fcffa899d3099479f7862774cfa85fe2d61cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00125-008-1224-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00125-008-1224-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21093525$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19057893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rabbani, N</creatorcontrib><creatorcontrib>Alam, S. S</creatorcontrib><creatorcontrib>Riaz, S</creatorcontrib><creatorcontrib>Larkin, J. R</creatorcontrib><creatorcontrib>Akhtar, M. W</creatorcontrib><creatorcontrib>Shafi, T</creatorcontrib><creatorcontrib>Thornalley, P. J</creatorcontrib><title>High-dose thiamine therapy for patients with type 2 diabetes and microalbuminuria: a randomised, double-blind placebo-controlled pilot study</title><title>Diabetologia</title><addtitle>Diabetologia</addtitle><addtitle>Diabetologia</addtitle><description>Aims/hypothesis High-dose supplements of thiamine prevent the development of microalbuminuria in experimental diabetes. The aim of this pilot study was to assess whether oral supplements of thiamine could reverse microalbuminuria in patients with type 2 diabetes. Methods Type 2 diabetic patients (21 male, 19 female) with microalbuminuria were recruited at the Diabetes Clinic, Sheikh Zayed Hospital, Lahore, Pakistan, and randomised to placebo and treatment arms. Randomisation was by central office in sequentially numbered opaque, sealed envelopes. Participants, caregivers and those assessing the outcomes were blinded to group assignment. Patients were given 3 x 100 mg capsules of thiamine or placebo per day for 3 months with a 2 month follow-up washout period. The primary endpoint was change in urinary albumin excretion (UAE). Other markers of renal and vascular dysfunction and plasma concentrations of thiamine were determined. Results UAE was decreased in patients receiving thiamine therapy for 3 months with respect to baseline (median -17.7 mg/24 h; p < 0.001, n = 20). There was no significant decrease in UAE in patients receiving placebo after 3 months of therapy (n = 20). UAE was significantly lower in patients who had received thiamine therapy compared with those who had received placebo (30.1 vs 35.5 mg/24 h, p < 0.01) but not at baseline. UAE continued to decrease in the 2 month washout period in both groups, but not significantly. There was no effect of thiamine treatment on glycaemic control, dyslipidaemia or BP. There were no adverse effects of therapy. Conclusions/interpretation In this pilot study, high-dose thiamine therapy produced a regression of UAE in type 2 diabetic patients with microalbuminuria. Thiamine supplements at high dose may provide improved therapy for early-stage diabetic nephropathy. Trial registration: CTRI (India) CTRI/2008/091/000112 Funding: Pakistan Higher Education Commission</description><subject>Albuminuria - prevention & control</subject><subject>Associated diseases and complications</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - urine</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic complications</subject><subject>Diabetic nephropathy</subject><subject>Double-Blind Method</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Glomerular Filtration Rate</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kidneys</subject><subject>Lipids - blood</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Microalbuminuria</subject><subject>Nephrology. Urinary tract diseases</subject><subject>noninsulin-dependent diabetes mellitus</subject><subject>Patients</subject><subject>Pilot Projects</subject><subject>Placebos</subject><subject>Plasma</subject><subject>Short Communication</subject><subject>thiamin</subject><subject>Thiamine - blood</subject><subject>Thiamine - therapeutic use</subject><subject>Thiamine - urine</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urinary tract. Prostate gland</subject><subject>Vitamin B</subject><issn>0012-186X</issn><issn>1432-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc2KFDEUhYMoTs_oA7jRIOjKaP6qksxOhtERBlzogLuQSlLdGdKVMkkh_Q4-tGmqccCFq4R7vnPv5R4AXhD8nmAsPhSMCe0QxhIRSjnij8CGcEYR5lQ-BpujjIjsf5yB81LuMcas4_1TcEYU7oRUbAN-34TtDrlUPKy7YPZhOn58NvMBjinD2dTgp1rgr1B3sB5mDyl0wQy--gLN5OA-2JxMHJbmXXIwl9DA3IS0D8W7d9ClZYgeDTE0eI7G-iEhm6aaU4y-lUJMFZa6uMMz8GQ0sfjnp_cC3H26_n51g26_fv5y9fEWWd73FVHLqbd4UJ45KyWnFLvBCNc7PtpxNFIpx7BSXKhRyJ4KwW2rdqOnrifWsQvwdu075_Rz8aXqtqv1MZrJp6XovhdKCoIb-Pof8D4teWq7aUqY5IRI1iCyQu0OpWQ_6jmHvckHTbA-5qTXnHTLSR9z0rx5Xp4aL8PeuwfHKZgGvDkBplgTx3ZRG8pfjhKsWEe7xtGVK02atj4_bPi_6a9W02iSNtvcGt99o5gwTDqhetmxP_ortgw</recordid><startdate>20090201</startdate><enddate>20090201</enddate><creator>Rabbani, N</creator><creator>Alam, S. 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S ; Riaz, S ; Larkin, J. R ; Akhtar, M. W ; Shafi, T ; Thornalley, P. J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-2c42ec0b9e3dc884220dba7d6d4fcffa899d3099479f7862774cfa85fe2d61cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Albuminuria - prevention & control</topic><topic>Associated diseases and complications</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - urine</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic complications</topic><topic>Diabetic nephropathy</topic><topic>Double-Blind Method</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Glomerular Filtration Rate</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Kidneys</topic><topic>Lipids - blood</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Microalbuminuria</topic><topic>Nephrology. Urinary tract diseases</topic><topic>noninsulin-dependent diabetes mellitus</topic><topic>Patients</topic><topic>Pilot Projects</topic><topic>Placebos</topic><topic>Plasma</topic><topic>Short Communication</topic><topic>thiamin</topic><topic>Thiamine - blood</topic><topic>Thiamine - therapeutic use</topic><topic>Thiamine - urine</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urinary tract. Prostate gland</topic><topic>Vitamin B</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rabbani, N</creatorcontrib><creatorcontrib>Alam, S. S</creatorcontrib><creatorcontrib>Riaz, S</creatorcontrib><creatorcontrib>Larkin, J. R</creatorcontrib><creatorcontrib>Akhtar, M. W</creatorcontrib><creatorcontrib>Shafi, T</creatorcontrib><creatorcontrib>Thornalley, P. 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S</au><au>Riaz, S</au><au>Larkin, J. R</au><au>Akhtar, M. W</au><au>Shafi, T</au><au>Thornalley, P. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-dose thiamine therapy for patients with type 2 diabetes and microalbuminuria: a randomised, double-blind placebo-controlled pilot study</atitle><jtitle>Diabetologia</jtitle><stitle>Diabetologia</stitle><addtitle>Diabetologia</addtitle><date>2009-02-01</date><risdate>2009</risdate><volume>52</volume><issue>2</issue><spage>208</spage><epage>212</epage><pages>208-212</pages><issn>0012-186X</issn><eissn>1432-0428</eissn><abstract>Aims/hypothesis High-dose supplements of thiamine prevent the development of microalbuminuria in experimental diabetes. The aim of this pilot study was to assess whether oral supplements of thiamine could reverse microalbuminuria in patients with type 2 diabetes. Methods Type 2 diabetic patients (21 male, 19 female) with microalbuminuria were recruited at the Diabetes Clinic, Sheikh Zayed Hospital, Lahore, Pakistan, and randomised to placebo and treatment arms. Randomisation was by central office in sequentially numbered opaque, sealed envelopes. Participants, caregivers and those assessing the outcomes were blinded to group assignment. Patients were given 3 x 100 mg capsules of thiamine or placebo per day for 3 months with a 2 month follow-up washout period. The primary endpoint was change in urinary albumin excretion (UAE). Other markers of renal and vascular dysfunction and plasma concentrations of thiamine were determined. Results UAE was decreased in patients receiving thiamine therapy for 3 months with respect to baseline (median -17.7 mg/24 h; p < 0.001, n = 20). There was no significant decrease in UAE in patients receiving placebo after 3 months of therapy (n = 20). UAE was significantly lower in patients who had received thiamine therapy compared with those who had received placebo (30.1 vs 35.5 mg/24 h, p < 0.01) but not at baseline. UAE continued to decrease in the 2 month washout period in both groups, but not significantly. There was no effect of thiamine treatment on glycaemic control, dyslipidaemia or BP. There were no adverse effects of therapy. Conclusions/interpretation In this pilot study, high-dose thiamine therapy produced a regression of UAE in type 2 diabetic patients with microalbuminuria. Thiamine supplements at high dose may provide improved therapy for early-stage diabetic nephropathy. Trial registration: CTRI (India) CTRI/2008/091/000112 Funding: Pakistan Higher Education Commission</abstract><cop>Berlin/Heidelberg</cop><pub>Berlin/Heidelberg : Springer-Verlag</pub><pmid>19057893</pmid><doi>10.1007/s00125-008-1224-4</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Albuminuria - prevention & control Associated diseases and complications Biological and medical sciences Blood Pressure Diabetes Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - urine Diabetes. Impaired glucose tolerance Diabetic complications Diabetic nephropathy Double-Blind Method Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Glomerular Filtration Rate Glycated Hemoglobin A - metabolism Human Physiology Humans Internal Medicine Kidneys Lipids - blood Medical sciences Medicine Medicine & Public Health Metabolic Diseases Microalbuminuria Nephrology. Urinary tract diseases noninsulin-dependent diabetes mellitus Patients Pilot Projects Placebos Plasma Short Communication thiamin Thiamine - blood Thiamine - therapeutic use Thiamine - urine Urinary system involvement in other diseases. Miscellaneous Urinary tract. Prostate gland Vitamin B |
| title | High-dose thiamine therapy for patients with type 2 diabetes and microalbuminuria: a randomised, double-blind placebo-controlled pilot study |
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