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

Area of Science:

• Endocrinology
• Metabolic pathways
• Diabetic complications

Background:

• Diabetic complications arise from reactive oxygen species-induced pathways.
• Advanced glycation end products (AGEs), hexosamine pathway, and prostacyclin synthase activity are key markers.
• Rodent models show promise for benfotiamine and alpha-lipoic acid in mitigating these pathways.

Purpose of the Study:

• To investigate if fixed doses of benfotiamine and slow-release alpha-lipoic acid can normalize complication-related pathways in humans.
• To assess the efficacy of this combination therapy in individuals with and without type 1 diabetes.

Main Methods:

• Male participants with and without type 1 diabetes were enrolled.
• Baseline glycaemic status was assessed using three indicators.
• Intracellular AGE formation, hexosamine pathway activity, and prostacyclin synthase activity were measured before and after 4 weeks of treatment.

Main Results:

• Treatment did not affect glycaemic indicators in type 1 diabetes participants.
• Benfotiamine plus alpha-lipoic acid normalized increased AGE formation.
• Hexosamine-modified proteins decreased by 40%, and prostacyclin synthase activity was normalized.

Conclusions:

• The beneficial effects observed in rodent models are replicated in humans with type 1 diabetes.
• Benfotiamine and alpha-lipoic acid combination therapy shows potential in managing diabetic complication pathways.
• This study provides human evidence for the therapeutic role of these agents in diabetic complications.