Benfotiamine Prevents Postprandial Symptoms in Diabetes

NEW YORK (Reuters Health) Sept 22 - Benfotiamine prevents the endothelial dysfunction and oxidative stress that follow a meal rich in advanced glycation end (AGE) products in type 2 diabetics, according to a report in the September issue of Diabetes Care.

"Benfotiamine was used for decades as a treatment of diabetic neuropathy, without any exact knowledge of the beneficial mechanism," Dr. Alin Stirban from Ruhr-University, Bochum, Germany told Reuters Health. "Our data bring benzoctamine from the relatively restricted field of diabetic neuropathy into the much larger field of vascular function and prove in humans effects previously postulated."

Dr. Stirban and colleagues investigated the effects of a real-life, cooked, AGE-rich meal on endothelial function and oxidative stress with or without benfotiamine pretreatment in 13 adults with type 2 diabetes.

The high-AGE meal significantly impaired endothelium-dependent vasodilatation, the authors report, but this impairment was completely prevented by benfotiamine.

The high-AGE meal, with or without benfotiamine pretreatment, did not affect endothelium-independent vasodilatation, the results indicate.

Benfotiamine pretreatment also prevented the decrease in reactive hyperemia and the increase in circulating markers of endothelial dysfunction, inflammation, and oxidative stress seen after a high-AGE meal, the researchers note. The beneficial effects of benfotiamine treatment were accompanied by lower serum levels of AGEs and dicarbonyls, the report indicates.

"Our study does not completely elucidate the mechanisms through which benfotiamine prevents postprandial vascular dysfunction but raises some hypotheses," the authors conclude. "Further studies are warranted to bring light into these subtle mechanisms."

"We intend to investigate in a placebo-controlled manner medium-term effects of benfotiamine on endothelial function," Dr. Stirban said. "But we will extend our observation also on other cell types of critical importance for people with diabetes, such as adipocytes."

Diabetes Care 2006;29:2064-2071.
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