Medicine, PIMSR, Parul University, Vadodara, Gujarat, India.
Nursing, University of Wollongong Faculty of Science Medicine and Health, Wollongong, New South Wales, Australia
BMJ Open. 2022 Aug 25;12(8):e059834. doi: 10.1136/bmjopen-2021-059834.
Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. To evaluate effectiveness of thiamine supplementation on glycaemic outcomes in patients with T2DM.
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. PUBMED, Tripdatabase, the Cochrane Central Register, National Institute of Health Clinical Database and Google Scholar were searched until December 2021 for RCTs. It was assessed using standardised critical appraisal instruments from the Joanna Briggs Institute for RCTs. Where possible, studies were pooled in a meta-analysis. Results were presented in a narrative format if statistical pooling was not possible.
Six trials involving 364 participants. : 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.
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. 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.
CRD42020170520.
已证实 2 型糖尿病（T2DM）患者存在硫胺素缺乏。膳食补充是控制血糖的经济策略。评估补充硫胺素对 T2DM 患者血糖控制的效果。
纳入评估硫胺素补充对 T2DM 成人血糖结局（HbA1c、空腹血糖（FBG）和/或餐后血糖（PPG））影响的研究。检索 PUBMED、Tripdatabase、Cochrane 中央注册、美国国立卫生研究院临床试验数据库和 Google Scholar，检索截止日期为 2021 年 12 月，纳入 RCTs。使用 Joanna Briggs 研究所的 RCT 标准化评价工具进行评估。如果无法进行统计学汇总，则以叙述性格式呈现结果。
纳入 6 项试验，共 364 名参与者。结果显示，100-900mg/天硫胺素或苯磷硫胺治疗长达 3 个月并未观察到对血糖结局有显著有益影响（HbA1c：MD，-0.02%，95%CI：-0.35 至 0.31；FBG：MD，-0.20mmol/L；95%CI：-0.69 至 0.29；PPG：MD，-0.20mmol/L，95%CI：-2.05 至 1.65（MD））。在 3 个月随访时，高密度脂蛋白（HDL）显著增加（MD，0.10；95%CI：0.10 至 0.20）。与安慰剂 150mg/天相比，120mg/天苯磷硫胺可降低三酰甘油水平（MD，-1.10；95%CI：-1.90 至-0.30），但在较高剂量下未显示出这一效果。
纳入的单中心试验仅发表于英文期刊，纳入研究样本量小，缺乏针对相同比较的试验以及不同的随访时间。补充硫胺素并不影响血糖结局，但可降低三酰甘油，同时升高高密度脂蛋白。需要开展多中心、设计良好的 RCT，使用更高剂量的硫胺素，并随访 1-2 年，以提供更好的证据。
PROSPERO 注册号：CRD42020170520。
