Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis
Background Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. Objective: To evaluate effectiveness of thiamine supplementation on glycaemic outcomes in patients with T2DM.Methods Eligibi...
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BMJ Publishing Group
2022-08-01
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| Series: | BMJ Open |
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| author | Ritin Fernandez Heidi Green Arti Muley Prasad Muley |
| author_facet | Ritin Fernandez Heidi Green Arti Muley Prasad Muley |
| author_sort | Ritin Fernandez |
| collection | DOAJ |
| description | Background Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. Objective: To evaluate effectiveness of thiamine supplementation on glycaemic outcomes in patients with T2DM.Methods Eligibility criteria: Studies that assessed effect of thiamine supplementation in adults with T2DM which measured glycaemic outcomes—HbA1c, fasting blood glucose (FBG) and/or postprandial blood glucose (PPG) were included. Information sources: PUBMED, Tripdatabase, the Cochrane Central Register, National Institute of Health Clinical Database and Google Scholar were searched until December 2021 for RCTs. Risk of bias: It was assessed using standardised critical appraisal instruments from the Joanna Briggs Institute for RCTs. Synthesis of results: Where possible, studies were pooled in a meta-analysis. Results were presented in a narrative format if statistical pooling was not possible.Results Included studies: Six trials involving 364 participants. Synthesis of results: No significant beneficial effects were observed on glycaemic outcomes with 100–900 mg/day of thiamine or benfotiamine for up to 3 months (HbA1c: MD, −0.02%, 95% CI: −0.35 to 0.31; FBG: MD,−0.20 mmol/L; 95% CI: −0.69 to 0.29; PPG: MD, – 0.20 mmol/L, 95% CI: −2.05 to 1.65 (mean difference, MD)). There was a significant increase in high-density lipoprotein (HDL) (MD, 0.10; 95% CI: 0.10 to 0.20) at 3-month follow-up. Benfotiamine reduced triglyceride level (MD, −1.10; 95% CI: −1.90 to –0.30) in 120 mg/day dose as compared with placebo 150 mg/day, however this was not demonstrated in higher doses.Discussion Limitations of evidence: Inclusion of single-centre trials published only in English, small sample sizes of included studies, lack of trials investigating outcomes for same comparisons and varying follow-up periods. Interpretation: Thiamine supplementation does not affect glycaemic outcomes, however reduces triglycerides while increasing HDL. Multicentre well-designed RCT with higher doses of thiamine and a follow-up period of 1–2 years will provide better evidence.PROSPERO registration number CRD42020170520. |
| format | Article |
| id | doaj-art-cb6f0593cf834b838e2d8b80966a16b6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-08-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-cb6f0593cf834b838e2d8b80966a16b62025-02-07T14:00:10ZengBMJ Publishing GroupBMJ Open2044-60552022-08-0112810.1136/bmjopen-2021-059834Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysisRitin Fernandez0Heidi Green1Arti Muley2Prasad Muley3School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia7 COUCH Health, Manchester, UKMedicine, PIMSR, Parul University, Vadodara, Gujarat, IndiaPediatrics, PIMSR, Parul University, Vadodara, Gujarat, IndiaBackground Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. Objective: To evaluate effectiveness of thiamine supplementation on glycaemic outcomes in patients with T2DM.Methods Eligibility criteria: Studies that assessed effect of thiamine supplementation in adults with T2DM which measured glycaemic outcomes—HbA1c, fasting blood glucose (FBG) and/or postprandial blood glucose (PPG) were included. Information sources: PUBMED, Tripdatabase, the Cochrane Central Register, National Institute of Health Clinical Database and Google Scholar were searched until December 2021 for RCTs. Risk of bias: It was assessed using standardised critical appraisal instruments from the Joanna Briggs Institute for RCTs. Synthesis of results: Where possible, studies were pooled in a meta-analysis. Results were presented in a narrative format if statistical pooling was not possible.Results Included studies: Six trials involving 364 participants. Synthesis of results: No significant beneficial effects were observed on glycaemic outcomes with 100–900 mg/day of thiamine or benfotiamine for up to 3 months (HbA1c: MD, −0.02%, 95% CI: −0.35 to 0.31; FBG: MD,−0.20 mmol/L; 95% CI: −0.69 to 0.29; PPG: MD, – 0.20 mmol/L, 95% CI: −2.05 to 1.65 (mean difference, MD)). There was a significant increase in high-density lipoprotein (HDL) (MD, 0.10; 95% CI: 0.10 to 0.20) at 3-month follow-up. Benfotiamine reduced triglyceride level (MD, −1.10; 95% CI: −1.90 to –0.30) in 120 mg/day dose as compared with placebo 150 mg/day, however this was not demonstrated in higher doses.Discussion Limitations of evidence: Inclusion of single-centre trials published only in English, small sample sizes of included studies, lack of trials investigating outcomes for same comparisons and varying follow-up periods. Interpretation: Thiamine supplementation does not affect glycaemic outcomes, however reduces triglycerides while increasing HDL. Multicentre well-designed RCT with higher doses of thiamine and a follow-up period of 1–2 years will provide better evidence.PROSPERO registration number CRD42020170520.https://bmjopen.bmj.com/content/12/8/e059834.full |
| spellingShingle | Ritin Fernandez Heidi Green Arti Muley Prasad Muley Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis BMJ Open |
| title | Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_full | Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_fullStr | Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_full_unstemmed | Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_short | Effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis |
| title_sort | effect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/12/8/e059834.full |
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