VOLUME 9 NUMBER 3 • SEPTEMBER 2012
123
SA JOURNAL OF DIABETES & VASCULAR DISEASE
EDUCATOR’S FOCUS
Thiamine is absorbed in the proximal small bowel, mainly through ac-
tive transport. The recommended daily intake of thiamine is 1.2 mg, ap-
proximately 0.5 mg per 1 000 kcal consumed.
Important food sources of thiamine include pork, red meat, wheat germ,
eggs, fish and legumes. Thiamine is virtually absent in food products con-
taining refined carbohydrates such as milled rice and simple sugars, yet
the metabolism of these foods requires relatively high amounts of thia-
mine and may lead to depletion. In subjects on thiamine-deficient diets,
total body thiamine stores can be depleted within two to three weeks.
Severe deficiency of thiamine can lead to wet or dry ber-beri or Wer-
nicke encephalopathy, depending on the tissues involved. Moderate
deficiency of thiamine may affect glucose metabolism and impact on
diabetes and related complications.
The prevalence of thiamine deficiency has been reported in 17 to 79% of
diabetic patients, although these studies include both type 1 and 2 diabetes
patients. Evidence for the effect of thiamine supplementation to reduce the
risk and severity of type 2 diabetes has been demonstrated in a number
of studies.
Hyperglycaemia results in the overproduction of oxygen free radicals,
which contributes to the progression of diabetes. The development of
complications during diabetes is also associated with oxidative stress. The
cardiovascular complications such as coronary artery disease, peripheral
vascular disease and stroke have been closely related to oxidative stress
during diabetes.
Cultured endothelial cells demonstrate reduced production of reactive
oxidative species and improved function in high glucose concentrations
in the presence of thiamine. Both of these characteristics are expected
to reduce the risk of diabetic complications and possibly reduce the risk
of diabetes itself.
In a double-blind, cross-over trial, the administration of benfotiamine,
a lipid-soluble thiamine analogue, improved endothelial function, reduced
markers of oxidative stress and reduced levels of advanced glycosylated
end-products following a test meal in type 2 diabetes patients.
Long-term studies investigating the use of thiamine supplementation
in diabetic patients have not been performed. The potential exists for
thiamine supplementation to modify the course of diabetes by modulation
of glucose metabolic pathways. Given high rates of thiamine deficiency in
diabetic patients, supplementation may be considered.
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It's the
shell that
makes
safer.
Safety-Coated
R
81
mg
The ORIGINAL low dose aspirin
for optimum cardio-protection
Hp
Each tablet contains Aspirin 81mg. Reg.No.: 29/2.7/0767
Pharmafrica (Pty) Ltd, 33 Hulbert Road, New Centre, Johannesburg 2001
Under licence from Goldshield Pharmaceuticals Ltd. U.K.
