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Emerging role of thiamine therapy for prevention and treatment of early-stage diabetic nephropathy
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Rabbani, Naila and Thornalley, Paul J.. (2011) Emerging role of thiamine therapy for prevention and treatment of early-stage diabetic nephropathy. Diabetes, Obesity and Metabolism, Vol.13 (No.7). pp. 577-583. ISSN 1462-8902
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Official URL: http://dx.doi.org/10.1111/j.1463-1326.2011.01384.x
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.
| Item Type: | Journal Article |
|---|---|
| Divisions: | Faculty of Medicine > Warwick Medical School > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School |
| Journal or Publication Title: | Diabetes, Obesity and Metabolism |
| Publisher: | Blackwell |
| ISSN: | 1462-8902 |
| Date: | July 2011 |
| Volume: | Vol.13 |
| Number: | No.7 |
| Page Range: | pp. 577-583 |
| Identification Number: | 10.1111/j.1463-1326.2011.01384.x |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Funder: | Diabetes UK |
| URI: | http://wrap.warwick.ac.uk/id/eprint/41562 |
Data sourced from Thomson Reuters' Web of Knowledge
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