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Thiamine, The Paradigm Shift in Diabetes

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Thiamine deficiency occurs in individuals with diabetes, which leads to hyperglycaemic-induced damage...Thiamine administration can prevent the formation of harmful by-products of glucose metabolism, reduce oxidative stress and improve endothelial function. The potential benefit of long-term replacement in those with diabetes is not yet known but may reduce cardiovascular risk and angiopathic complications."

A review article from 2012 in the Journal of Clinical Medicine by Dr Luong (9) discusses the mechanisms by which thiamine prevents the complications of diabetes.  He writes:

"Thiamine definitively has a role in the diabetic endothelial vascular diseases (micro and macroangiopathy), lipid profile, retinopathy, nephropathy, cardiopathy, and neuropathy."(9)

Thiamine Treats Elevated Cholesterol and Triglycerides of Diabetes

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Thiamine prevents diabetes-induced increases in plasma cholesterol and triglycerides in an animal model.(12,13)  High-dose thiamine therapy counteracts diabetes-induced cardiac fibrosis in the same animal model. (14)

Thiamine Accelerates Healing of Diabetic Wounds

diabetic foot and toes thiamine deficiency benfotiamine
Above image: Typical changes of diabetic foot and toes caused by combined sensory neuropathy and vascular disease of diabetes. by Wikimedia Commons

A study by Dr Gadau in Italy published in Diabetologia in 2006 using diabetic mice showed that a lipid-soluble form of thiamine called Benfotiamine accelerates healing of diabetic wounds (left image) produced by hindlimb ischemia.(15) The authors found that
"benfotiamine prevented ischaemia-induced toe necrosis, improved hindlimb perfusion and oxygenation, and restored endothelium-dependent vasodilation. (15)" 
The thiamine-treated animals had improved growth of new blood vessels and reduced cell death in the ischemic areas.  Reduced EPCs (endothelial-progenitor cells) in the control animals was restored to normal in thiamine-treated animals.  This is beneficial for healing since the EPCs are the stem cells that heal the vessel walls and help to form collateral vessel formation in healing tissues.(15)
More on Benfotiamine

Benfotiamine (thiamine) prevents diabetic retinopathy(16), polyneuropathy (17), and,  since it is lipid soluble and highly absorbable, may be the most effective of thiamine compounds.  Benfotiamine produces beneficial effects on general nerve health, sciatica, neuropathy, retinopathy, nephropathy, polyneuropathy, peripheral neuropathy (PN), shingles, herpes zoster, and  vascular health for diabetics and non-diabetics alike. (18)(19)

Diabetes Drugs: More Is Not Always Better.

The ACCORD trial was devised to test the theory that reducing blood sugar and HgbA1C in diabetics to near-normal levels would decrease the incidence of cardiovascular disease.(1E)   However , they found the exact opposite. 

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The large NIH Diabetes study, ACCORD, was halted early because of higher mortality in the lower blood-sugar groups (the intensive-treatment group), as reported in a New York Times article by Gina Kolata.   This shocked and stunned the medical community because it has always been believed that the closely or "tightly controlled" blood sugar had the best clinical results for diabetes.  This was proven wrong.

Dr RW Donnell concludes from the ACCORD study:

1) Intensive glycemic control in Type Two Diabetes does not prevent vascular disease.

2) Diabetic Drugs, including insulin, have the potential for macrovascular harm.

The ACCORD Study Did Not Give Thiamine to The Diabetic Patients

Why did this happen?  The answer is obvious.  Using high-dose insulin to drive blood sugar into thiamine-deficient cells can be harmful.  The cells are pumped full of glucose that they cannot metabolize because of thiamine deficiency.  Instead, the glucose is shunted into alternate pathways creating harmful and damaging metabolites, which cause accelerated vascular disease.

Conclusion - Overwhelming Evidence

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I was taught in medical school that diabetes was caused by either inadequate insulin production (type I) or insensitivity to insulin (type II diabetes).  This is not the complete story, and a paradigm shift has occurred in thinking about the underlying mechanism of diabetes. Current research reveals that diabetes is a thiamine-deficiency state, which is the primary cause of diabetic complications.  The evidence is now overwhelming that treatment of the diabetic patient should include  thiamine supplementation, preferably in the form of benfotiamine, which is inexpensive, readily available, and has no adverse effects.

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Jeffrey Dach MD is a physician and author of two books, Natural Medicine 101, and Bioidentical Hormones 101, both available on Amazon, or as a free e-book on his web sites. Dr. Dach is founder and chief medical officer of TrueMedMD, a clinic in (more...)

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