A study published in the August 4, 2007 of Diabetologica conclusively shows that diabetic patients are deficient in B1 (thiamine) in blood plasma. Deficiency of thiamine may be critical in many vascular problems people with diabetes face, researchers at Warwick Medical School, University of Warwick, have revealed. They have also solved the mystery as to why thiamine deficiency in diabetes had remained hidden up until now.
Diabetes is increasing in incidence globally. Estimates from the World Health Organization put the number of people affected at 171 million; that figure is expected to double by 2030. One of the most momentous health problems associated with diabetes is vascular complications: microvascular complications, such as damage to the kidney, retina and nerves in arms and legs; and macrovascular complications, such as heart disease and stroke.
Previously Masked Deficiency
The study found that thiamine concentration in blood plasma was decreased 76% in type 1 diabetic patients and 75% in type 2 diabetic patients.
This decrease had previously been masked. The standard way of assessing levels of thiamine status is by measuring activity of an enzyme called transketolase in red blood cells.
Past diabetic blood studies had recorded normal activity of this enzyme and assumed normal levels of thiamine. In fact the normal enzyme activity was due to increased amounts of two proteins THTR-1 and RFC-1 that help transport thiamine into red blood cells.
Much like antibodies responding to an infection, increased levels of these proteins were a direct response to there being a deficiency of thiamine in the body.
It likely reflects problems in endothelial cells, which are the cells that line the bodys entire circulatory system. Increased risk of atherosclerosis, the chronic inflammatuion of artery walls, may also be implicated.
Interestingly, researchers discovered that the decreased plasma thiamine levels in clinical diabetes were caused by a deficiency of thiamine in the diet. The deficiency is due to acutely increased rates of removal of thiamine from the blood into the urine.
Future study needs to look at thiamine levels in diabetic populations of other countries, independent of local diet, as well as the evaluation of thiamine and thiamine derivatives to correct low plasma thiamine concentration in diabetes. Investigation into the mechanism of increased removal of thiamine from the blood into the urine in diabetics is would also be worthwhile, the team feels.
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