Oral benfotiamine plus alpha-lipoic acid normalises complication-causing pathways in type 1 diabetes

Diabetologia. 2008 Oct;51(10):1930-2. doi: 10.1007/s00125-008-1100-2. Epub 2008 Jul 29.

Abstract

Aims/hypothesis: We determined whether fixed doses of benfotiamine in combination with slow-release alpha-lipoic acid normalise markers of reactive oxygen species-induced pathways of complications in humans.

Methods: Male participants with and without type 1 diabetes were studied in the General Clinical Research Centre of the Albert Einstein College of Medicine. Glycaemic status was assessed by measuring baseline values of three different indicators of hyperglycaemia. Intracellular AGE formation, hexosamine pathway activity and prostacyclin synthase activity were measured initially, and after 2 and 4 weeks of treatment.

Results: In the nine participants with type 1 diabetes, treatment had no effect on any of the three indicators used to assess hyperglycaemia. However, treatment with benfotiamine plus alpha-lipoic acid completely normalised increased AGE formation, reduced increased monocyte hexosamine-modified proteins by 40% and normalised the 70% decrease in prostacyclin synthase activity from 1,709 +/- 586 pg/ml 6-keto-prostaglandin F(1alpha) to 4,696 +/- 533 pg/ml.

Conclusions/interpretation: These results show that the previously demonstrated beneficial effects of these agents on complication-causing pathways in rodent models of diabetic complications also occur in humans with type 1 diabetes.

Trial registration: ClinicalTrials.gov NCT00703989.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Analysis of Variance
  • Cytochrome P-450 Enzyme System / metabolism
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / metabolism
  • Drug Therapy, Combination
  • Glycation End Products, Advanced / metabolism
  • Hexosamines / metabolism
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / drug therapy
  • Hyperglycemia / metabolism
  • Intramolecular Oxidoreductases / metabolism
  • Male
  • Oxidative Stress / drug effects*
  • Thiamine / administration & dosage
  • Thiamine / analogs & derivatives*
  • Thiamine / therapeutic use
  • Thioctic Acid / administration & dosage
  • Thioctic Acid / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Glycation End Products, Advanced
  • Hexosamines
  • Thioctic Acid
  • Cytochrome P-450 Enzyme System
  • Intramolecular Oxidoreductases
  • prostacyclin synthetase
  • Thiamine
  • benphothiamine

Associated data

  • ClinicalTrials.gov/NCT00703989