High-dose thiamine therapy for patients with type 2 diabetes and microalbuminuria: a randomised, double-blind placebo-controlled pilot study

Randomized, double-blind, placebo-controlled pilot trial in adults with type 2 diabetes and persistent microalbuminuria recruited from a diabetes clinic in Lahore, Pakistan. For the thiamine arm, 20 participants were randomized; mean age was 52.7±8.4 years and mean BMI was 28.1±4.6 kg/m2.

Oral thiamine 300 mg/day, given as 3 x 100 mg capsules daily for 3 months, was compared with placebo in adults with type 2 diabetes and persistent microalbuminuria.

High-dose thiamine lowered urinary albumin excretion and reversed microalbuminuria toward normal in some patients. In the thiamine arm, median UAE fell from 43.7 (33.0-120.9) mg/24 h at baseline to 30.1 (12.0-38.2) mg/24 h after 3 months, with a change from baseline of -17.7 mg/24 h (p<0.001). Post-treatment UAE was also lower than placebo (30.1 vs 35.5 mg/24 h; p<0.01). No significant effects were seen on glycaemic control, dyslipidaemia, or blood pressure, and no adverse effects were reported.

Pilot study with a small active-arm sample and short 3-month duration, limiting certainty about durability and clinical impact. Conducted at a single clinic in Lahore, which may limit generalizability. The report did not show benefit on glycaemic control, lipids, or blood pressure, so the effect was specific to urinary albumin excretion.