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None of the currently available therapeutic interventions for type 2 diabetes mellitus address the intracellular metabolism of glucose through the main energy pathways of the cell. Thiamine (vitamin B1) is a water-soluble vitamin and essential normal dietary component. When modified in the body to the pyrophosphate derivative, it acts as a coenzyme for pyruvate dehydrogenase, alpha-ketoglutarate dehydrogenase & transketolase which are required for the utilization and consumption of glycolytic and hexose monophosphate pathway intermediates & form an integral part of intracellular and glucose metabolism. Thiamine deficiency decreases the activities of these enzymes, leading to imbalances in the metabolic pathways. The effects of these imbalances are more pronounced in diabetes mellitus where renal dysfunction produces mild thiamine deficiency.This indepth review presents a novel perspective on, the cellular energy cycles ,thiamine dependant enzymes,pharmacotherapeutics of type 2 diabetes especially thiamine and their impact on type 2 diabetes treatment.Thiamine, with its well established safety record, easy accessibility and affordability could be an invaluable adjunct for our type 2 diabetic population and help to improve the quality of their lives by giving them some respite from the complications of type 2 diabetes and perhaps reduce the need of more expensive oral hypoglycaemic agents required by them.

Thiamine and the Cellular Energy Cycles — A Novel Perspective on Type 2 Diabetes Treatment