Abstract
Once diagnosed with diabetes mellitus, the risk of diseases, such as nephropathy, neuropathy, retinopathy and heart disease also increases. The complication of diabetes accompanying myocardial disorder is known as diabetic cardiomyopathy, which is characterized by ventricular dilation that is usually asymptomatic as diabetes progresses. Myocardial fibrosis is closely related to diastolic dysfunction. Thiamine (vitamin B1), an essential micronutrient, has been reported to attenuate diabetic complications and all diabetics may be lacking in thiamine. Thiamine is a coenzyme utilized at multiple steps of glucose metabolism. We believe that thiamine repletion under hyperglycemia might activate glucose oxidation and reduce the overflow of glucose to the hexosamine biosynthesis pathway of glucose metabolism with concomitant reduction of diabetic lesions. The aim of this article is to highlight the role of thiamine, an important factor that combats diabetic complications, especially diabetic cardiomyopathy and also elucidate its impact on O-glycosylated protein in diabetes. Finally, we discuss the ability of thiamine repletion to prevent metabolic syndrome and obesity, which are considered prediabetic states, as well as prediabetic cardiomyopathy.
Highlights
Diabetes mellitus, a well recognized risk factor for the development of heart failure, was initially linked to heart disease 30 years ago with the Framingham Heart Study [1,2,3,4,5,6,7]
Rubler et al propounded the concept that diabetic cardiac failure without coronary lesions is classified as diabetic cardiomyopathy and it is caused by systolic and diastolic dysfunction due to diabetes itself [8]
Our laboratory data have clearly demonstrated the effect of thiamine repletion on cardiac fibrosis, which contributes to heart failure in streptozotocin-induced diabetic rats [35]
Summary
A well recognized risk factor for the development of heart failure, was initially linked to heart disease 30 years ago with the Framingham Heart Study [1,2,3,4,5,6,7]. Cardiac failure in diabetes is primarily due to ischemic heart disease caused by coronary artery disease. It is proposed that the incidence of heart failure in diabetes, except for atherosclerotic coronary lesions, is 4-5 times higher compared to nondiabetics. Patients with heart failure are at a higher risk of developing diabetes [9]. It has been revealed that there is a significant overlap in the development of both diabetes and cardiac failure. We believe that thiamine has the ability to increase carbohydrate metabolism and the amount of catalytic thiamine absorbed must necessarily increase if glucose is to be metabolized in large quantities
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