CClinicalTrials.gg
CompletedNCT03717896Updated Jun 23, 2026Results posted

Thiamine as Adjunctive Therapy for Diabetic Ketoacidosis

A Phase 2 interventional study of 200mg IV thiamine in 50mL 0.9% saline and Placebo in Diabetic Ketoacidosis, sponsored by Beth Israel Deaconess Medical Center. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-23.

Sponsored by Beth Israel Deaconess Medical Center · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
102
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a randomized, double-blind, placebo-controlled trial to determine if administration of intravenous thiamine will lead to quicker resolution of acidosis in patients admitted to the hospital with diabetic ketoacidosis. The investigators will secondarily investigate whether thiamine improves cellular oxygen consumption, shortens intensive care unit (ICU) and hospital stay or decreases hospital resource utilization.

Read the detailed description

Thiamine (vitamin B1) is a water-soluble vitamin that plays a key role in aerobic glucose metabolism. Thiamine is a cofactor of pyruvate dehydrogenase (PDH), an enzyme that must be activated for entry into the Krebs Cycle for aerobic metabolism. PDH activity is reduced in thiamine deficient states, resulting in a shift in pyruvate metabolism to the anaerobic pathway. This leads to increased lactate production and acidosis. Thiamine loss in the urine, with consequent thiamine deficiency, is not uncommon in diabetes. The investigators' preliminary studies have found that thiamine deficiency in occurs in as many as 39% of patients with DKA, and that thiamine levels are inversely associated with lactate and acidosis. The investigator hypothesizes that treating DKA patients with intravenous thiamine will lead to faster resolution of acidosis and improved aerobic metabolism. The investigator's secondary hypothesis is that thiamine treatment will shorten stays in the ICU and hospital and lead to utilization of fewer hospital resources.

In this randomized, double-blind, placebo-controlled trial, patients admitted to the hospital with DKA who are enrolled in the study will be randomized to either intravenous thiamine (200mg in 0.9% saline) twice daily for two days or an identical volume of 0.9% saline on the same schedule. The investigator's primary outcome is change in bicarbonate over the 24 hours following enrollment, with measurements at 0, 6, 12, 18, 24 hours, using a linear mixed-effects model. Secondarily, patients will be stratified by Type I and Type II DM. Additionally, a pre-planned sub-analysis of thiamine deficient subjects will be performed.

02

Conditions studied

  • Diabetic Ketoacidosis

Keywords

  • diabetic ketoacidosis
  • DKA
  • thiamine
  • acidosis
  • oxygen consumption
  • lactate
03

In context

Diabetic Ketoacidosis

80 studies on the registry are indexed under Diabetic Ketoacidosis; 15 are open to participants now.

This study's enrollment of 102 is above the median of 59 across 46 interventional studies indexed under Diabetic Ketoacidosis.

Browse Diabetic Ketoacidosis studies →

Lead sponsor

Beth Israel Deaconess Medical Center is the lead sponsor of 560 studies on the registry; 80 are open to participants now.

Of its 75 completed or terminated interventional studies of FDA-regulated products, 61 (81%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Bicarbonate ≤15 mEq/L
  • Anion gap > 12 mEq/L
  • Blood pH≤ 7.24 (if already obtained by clinical team)
  • Urine ketones (qualitative) or serum ketones (β-hydroxybutyric acid) > 3 mmol/L
  • Enrollment within 6 hours of presentation

Exclusion criteria

Exclusion Criteria:

  • Current thiamine supplementation ≥ 6 milligrams per day (i.e., more than a multivitamin)
  • Competing causes of severe acidosis including seizure, carbon monoxide poisoning, cyanide toxicity, cardiac arrest, liver dysfunction (specifically defined as known cirrhosis)
  • Known allergy to thiamine
  • Competing indication for thiamine administration as judged by the clinical team (e.g., significant alcohol use)
  • Research-protected populations (pregnant women and prisoners)
  • Patient enrolled previously in same study
  • Code status of Do Not Resuscitate/Do Not Intubate (DNR/DNI) or Comfort Measures Only (CMO)
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
102 participants (actual)

Study arms

  • Experimental
    Thiamine

    200mg IV thiamine in 50mL 0.9% saline twice daily for 2 days

    Drug: 200mg IV thiamine in 50mL 0.9% saline

  • Placebo comparator
    Placebo

    100mL 0.9% saline twice daily for two days

    Drug: Placebo

Interventions

  • Drug200mg IV thiamine in 50mL 0.9% saline

    Thiamine 200mg IV every 12 hours for 2 days

    Also known as: Vitamin B1

  • DrugPlacebo

    50mL 0.9% saline

06

What researchers measure

Primary outcomes

  1. Plasma Bicarbonate Levels

    Primary outcome of plasma bicarbonate levels over 24 hours (6, 12, 18, 24 hours) following enrollment

    Time frame: 6, 12, 18, and 24 hours after enrollment

Secondary outcomes

  1. Lactate

    Secondary outcome of lactate over 24 hours (6, 12, 18, 24 hours) following enrollment

    Time frame: 6, 12, 18, and 24 hours after enrollment

  2. Anion Gap

    Secondary outcome of anion gap over 24 hours (6, 12, 18, 24 hours) following enrollment

    Time frame: 6, 12, 18, and 24 hours after enrollment

  3. ICU Length of Stay

    ICU length of stay reflects the number of ICU admission days.

    Time frame: 45 days

  4. Hospital Length of Stay

    Hospital length of stay reflects how long it takes a diabetic ketoacidosis patient to recover to the point where he/she can be released from the hospital.

    Time frame: 45 days

  5. Duration of Insulin Therapy

    The duration of insulin therapy is calculated by examining the hospital clinical information systems for all records of IV insulin infusion beginning at the time of enrollment. The start and the stop time-stamps of medication infusion are used to calculate a duration of infusion.

    Time frame: First 7 days after enrollment

  6. SOFA Score (Sequential Organ Failure Assessement Score)

    The SOFA score is a validated measure of organ dysfunction commonly used in critically ill patients, particularly those with sepsis. It evaluates the function of six organ systems-respiratory, cardiovascular, neurologic, hepatic, renal, and coagulation-based on routinely collected clinical and laboratory data. Each organ system is assigned a score from 0 (normal function) to 4 (most severe dysfunction), resulting in a total score ranging from 0 to 24. Higher SOFA scores indicate greater severity of organ failure and a higher risk of adverse outcomes. SOFA score in this study uses a modification in which the arterial oxygen saturation/fraction of inspired oxygen (SaO2 /FiO2) ratio is substituted for the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2 /FiO2 ratio).

    Time frame: 24 hours

  7. Oxygen Consumption by Circulating Mononuclear Cells

    Oxygen consumption rate of circulating peripheral blood mononuclear cells measured using Seahorse. Basal respiration represents oxygen consumption under baseline conditions. ATP-linked respiration represents oxygen consumption coupled to ATP production, while proton leak represents oxygen consumption not linked to ATP synthesis. Maximal respiration represents the maximal capacity of the electron transport chain after uncoupling. Spare respiratory capacity represents the difference between maximal and basal respiration and indicates the ability to respond to increased energy demand. Non-mitochondrial respiration represents oxygen consumption independent of mitochondrial activity.

    Time frame: 24 hours

  8. Pyruvate Dehydrogenase Activity

    Secondary outcome of change in PDH specific activity over 72 hours or at discharge if patient's hospital length of stay was less than 72 hours. PDH activity and total PDH protein quantity were measured in isolated peripheral blood mononuclear cells (PBMCs) following selective disruption of the mitochondrial membrane, using a previously validated immunocapture and microplate-based enzymatic assay protocol. PDH-specific activity was calculated as the ratio of measured PDH enzymatic activity to the natural logarithm of PDH protein quantity (PDH activity / ln\[PDH quantity\]), providing a normalized metric that reflects the functional efficiency of the enzyme independent of its expression level. Higher values suggest higher enzymatic efficiency.

    Time frame: 24 hours and 72 hours (or at discharge if hostpial length of stay was less than 72 hours)

  9. Neurocognitive: Hopkins Verbal Learning Test - Total Recall

    The Hopkins Verbal Learning Test-Revised (HVLT-R) Total Recall score is a measure of verbal learning and immediate memory. Participants are read a list of 12 words (from three semantic categories) and asked to recall as many words as possible across three consecutive learning trials. The Total Recall score is calculated as the sum of correctly recalled words across the three trials, yielding a possible range of 0 to 36, with higher scores indicating better verbal learning and memory performance. This score reflects both initial acquisition and short-term retention of verbal information and is commonly used to assess cognitive function in clinical research.

    Time frame: At hospital discharge, median of 4 days

  10. Neurocognitive: Hopkins Verbal Learning Test - Delayed Recall

    The Hopkins Verbal Learning Test-Revised (HVLT-R) Delayed Recall score assesses retention of verbal information after a delay. Following completion of the three learning trials, participants are asked to recall the previously presented word list after a delay period (typically 20-25 minutes) without re-exposure to the words. The Delayed Recall score is calculated as the number of correctly recalled words, with a possible range of 0 to 12, where higher scores indicate better memory retention. This measure reflects the ability to consolidate and retrieve learned information over time and is commonly used to evaluate memory function in clinical and research settings.

    Time frame: At hospital discharge, median of 4 days

  11. Neurocognitive: Hopkins Verbal Learning Test - Retention

    The Hopkins Verbal Learning Test-Revised (HVLT-R) Retention (%) score reflects the proportion of learned information that is retained over a delay. It is calculated as the ratio of the Delayed Recall score to the highest number of words recalled on any of the three immediate recall trials, multiplied by 100, yielding a percentage value. Scores typically range from 0% to 100%, with higher values indicating better retention of previously learned material. This measure provides an index of memory retention independent of initial learning performance.

    Time frame: At hospital discharge, median of 4 days

  12. Neurocognitive: Hopkins Verbal Learning Test - Recognition Discrimination Index

    The Hopkins Verbal Learning Test-Revised (HVLT-R) Recognition Discrimination Index assesses recognition memory by evaluating the ability to distinguish previously learned words from novel distractors. During the recognition phase, participants are presented with a list of target words and distractor words and asked to identify those that were previously learned. The Recognition Discrimination Index is calculated as the number of true positives (correctly identified target words) minus the number of false positives (incorrectly identified distractor words), yielding a score typically ranging from -12 to 12. Higher scores indicate better recognition accuracy and discrimination ability, reflecting the integrity of memory retrieval processes.

    Time frame: At hospital discharge, median of 4 days

  13. Neurocognitive: Brief Visuospatial Memory Test

    The Brief Visuospatial Memory Test (BVMT) assesses visuospatial learning and memory. Participants are shown six geometric designs for a brief period and asked to reproduce them from memory across three learning trials. Performance is scored based on the accuracy and placement of each design, with a total recall score ranging from 0 to 36, where higher scores indicate better visuospatial memory. A delayed recall trial is administered after a delay to assess retention of visual information. This measure evaluates the ability to encode, store, and retrieve visuospatial material.

    Time frame: At hospital discharge, median of 4 days

  14. Neurocognitive: Trail Making Test - Test Part A

    The Trail Making Test Part A (TMT-A) assesses visual attention, processing speed, and psychomotor function. Participants are instructed to connect numbered circles in sequential order as quickly as possible. The primary outcome is the time to completion, measured in seconds, with lower times indicating better performance. There is no fixed maximum score, although testing is typically discontinued at a predefined time limit (commonly 300 seconds).

    Time frame: At hospital discharge, median of 4 days

  15. Neurocognitive: Trail Making Test - Test Part B

    The Trail Making Test Part B (TMT-B) assesses executive function, including cognitive flexibility and set-shifting, in addition to processing speed. Participants are required to alternate between numbers and letters in sequence (e.g., 1-A-2-B) as quickly as possible. The primary outcome is the time to completion, measured in seconds, with lower times indicating better performance. As with TMT-A, there is no fixed maximum score, and testing is typically discontinued at a predefined time limit (commonly 300 seconds).

    Time frame: At hospital discharge, median of 4 days

  16. Neurocognitive: WAIS-IV Digit Span

    The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Digit Span subtest assesses attention, working memory, and concentration. Participants are asked to repeat sequences of numbers in forward order (Digit Span Forward), reverse order (Digit Span Backward), and ascending order (Digit Span Sequencing). Scores are based on the total number of correctly recalled sequences, with higher scores indicating better attention and working memory capacity. The total score ranges from 0 to 48.

    Time frame: At hospital discharge, median of 4 days

  17. Neurocognitive: Test of Verbal Fluency and Animal Naming

    The Animal Naming test is a measure of semantic verbal fluency and executive function. Participants are asked to name as many animals as possible within a fixed time period. The score is the total number of unique, correct animal names generated, with higher scores indicating better semantic memory retrieval and executive functioning. Scores range from 0 with no fixed upper limit.

    Time frame: At hospital discharge, median of 4 days

  18. Neurocognitive: Test of Premorbid Functioning

    The Test of Premorbid Functioning (TOPF) estimates an individual's baseline cognitive ability prior to illness or injury. Participants are asked to read aloud a list of irregularly spelled words, and performance is scored based on correct pronunciation. Scores are used to estimate premorbid intellectual functioning. Scores range from 0 to 70, with higher scores indicating higher estimated premorbid functioning. This measure helps contextualize current cognitive performance relative to expected baseline levels.

    Time frame: At hospital discharge, median of 4 days

Other outcomes

  1. C-peptide Levels

    C-peptide levels measured at time of study drug administration, 24 hours, and at 72 hours (or at discharge if hospital length of stay was less than 72 hours).

    Time frame: 0, 24 hours, and 72 hours (or at discharge if hospital length of stay was less than 72 hours)

07

Results

Posted Jun 23, 2026

Participant flow

Participant flow — Overall Study
MilestoneThiaminePlacebo
Started5349
Completed5248
Not completed11

Outcome measures

PrimaryPlasma Bicarbonate Levels

Primary outcome of plasma bicarbonate levels over 24 hours (6, 12, 18, 24 hours) following enrollment

Time frame:
6, 12, 18, and 24 hours after enrollment
Reported as:
Mean · mEq/L
Plasma Bicarbonate Levels
mEq/LThiaminePlacebo
6 hours15.3 ± 4.514.1 ± 4.7
12 hours16.4 ± 4.216.2 ± 3.7
18 hours17.2 ± 3.916.9 ± 3.8
24 hours18.3 ± 3.618.3 ± 2.8
SecondaryLactate

Secondary outcome of lactate over 24 hours (6, 12, 18, 24 hours) following enrollment

Time frame:
6, 12, 18, and 24 hours after enrollment
Reported as:
Median · mmol/L
Lactate
mmol/LThiaminePlacebo
6 hours1.3 (1.0 to 2.0)1.0 (0.9 to 1.5)
12 hours1.1 (0.9 to 1.5)1.0 (0.8 to 1.2)
18 hours1.0 (0.8 to 1.4)1.0 (0.8 to 1.4)
24 hours1.1 (0.9 to 1.4)1.2 (1.0 to 1.4)
SecondaryAnion Gap

Secondary outcome of anion gap over 24 hours (6, 12, 18, 24 hours) following enrollment

Time frame:
6, 12, 18, and 24 hours after enrollment
Reported as:
Median · mEq/L
Anion Gap
mEq/LThiaminePlacebo
6 hours16 (13 to 18)15 (12 to 18)
12 hours13 (11 to 16)12 (11 to 14)
18 hours12 (10 to 14)13 (10 to 14)
24 hours12 (10 to 16)12 (10 to 13)
SecondaryICU Length of Stay

ICU length of stay reflects the number of ICU admission days.

Time frame:
45 days
Reported as:
Median · days
ICU Length of Stay
daysThiaminePlacebo
ICU Length of Stay1.2 (0.9 to 1.7)1.5 (1.0 to 2.1)
SecondaryHospital Length of Stay

Hospital length of stay reflects how long it takes a diabetic ketoacidosis patient to recover to the point where he/she can be released from the hospital.

Time frame:
45 days
Reported as:
Median · days
Hospital Length of Stay
daysThiaminePlacebo
Hospital Length of Stay3.9 (2.3 to 6.1)4.2 (2.9 to 5.7)
SecondaryDuration of Insulin Therapy

The duration of insulin therapy is calculated by examining the hospital clinical information systems for all records of IV insulin infusion beginning at the time of enrollment. The start and the stop time-stamps of medication infusion are used to calculate a duration of infusion.

Time frame:
First 7 days after enrollment
Reported as:
Median · hours
Duration of Insulin Therapy
hoursThiaminePlacebo
Duration of Insulin Therapy18 (13 to 29)19 (14 to 29)
SecondarySOFA Score (Sequential Organ Failure Assessement Score)

The SOFA score is a validated measure of organ dysfunction commonly used in critically ill patients, particularly those with sepsis. It evaluates the function of six organ systems-respiratory, cardiovascular, neurologic, hepatic, renal, and coagulation-based on routinely collected clinical and laboratory data. Each organ system is assigned a score from 0 (normal function) to 4 (most severe dysfunction), resulting in a total score ranging from 0 to 24. Higher SOFA scores indicate greater severity of organ failure and a higher risk of adverse outcomes. SOFA score in this study uses a modification in which the arterial oxygen saturation/fraction of inspired oxygen (SaO2 /FiO2) ratio is substituted for the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2 /FiO2 ratio).

Time frame:
24 hours
Reported as:
Median · units on a scale
SOFA Score (Sequential Organ Failure Assessement Score)
units on a scaleThiaminePlacebo
SOFA Score (Sequential Organ Failure Assessement Score)1 (0 to 2)0 (0 to 0)
Other pre-specifiedC-peptide Levels

C-peptide levels measured at time of study drug administration, 24 hours, and at 72 hours (or at discharge if hospital length of stay was less than 72 hours).

Time frame:
0, 24 hours, and 72 hours (or at discharge if hospital length of stay was less than 72 hours)
Reported as:
Median · pmol/L
C-peptide Levels
pmol/LThiaminePlacebo
Baseline97.3 (7.4 to 524.1)24.0 (0.8 to 275.5)
24 hours92.0 (11.7 to 521.2)36.0 (0.8 to 483.0)
72 hours (or at discharge if hospital length of stay was less than 72 hours)167.5 (2.9 to 883.7)39.8 (0.8 to 570.5)
SecondaryOxygen Consumption by Circulating Mononuclear Cells

Oxygen consumption rate of circulating peripheral blood mononuclear cells measured using Seahorse. Basal respiration represents oxygen consumption under baseline conditions. ATP-linked respiration represents oxygen consumption coupled to ATP production, while proton leak represents oxygen consumption not linked to ATP synthesis. Maximal respiration represents the maximal capacity of the electron transport chain after uncoupling. Spare respiratory capacity represents the difference between maximal and basal respiration and indicates the ability to respond to increased energy demand. Non-mitochondrial respiration represents oxygen consumption independent of mitochondrial activity.

Time frame:
24 hours
Reported as:
Median · pmol O₂/min/10⁶ cells
Oxygen Consumption by Circulating Mononuclear Cells
pmol O₂/min/10⁶ cellsThiaminePlacebo
Non-mitochondrial3.5 (2.3 to 4.8)4.1 (2.1 to 5.7)
Basal5.7 (4.1 to 9.2)6.2 (2.7 to 9.8)
Max22.3 (16.2 to 28.9)21.2 (9.1 to 36.9)
ATP5.8 (3.3 to 7.7)5.5 (2.9 to 8.7)
Proton Leak0.22 (-0.09 to 1.02)0.07 (-0.24 to 0.65)
Spare14.7 (8.8 to 23.5)14.6 (6.4 to 28.0)
SecondaryPyruvate Dehydrogenase Activity

Secondary outcome of change in PDH specific activity over 72 hours or at discharge if patient's hospital length of stay was less than 72 hours. PDH activity and total PDH protein quantity were measured in isolated peripheral blood mononuclear cells (PBMCs) following selective disruption of the mitochondrial membrane, using a previously validated immunocapture and microplate-based enzymatic assay protocol. PDH-specific activity was calculated as the ratio of measured PDH enzymatic activity to the natural logarithm of PDH protein quantity (PDH activity / ln\[PDH quantity\]), providing a normalized metric that reflects the functional efficiency of the enzyme independent of its expression level. Higher values suggest higher enzymatic efficiency.

Time frame:
24 hours and 72 hours (or at discharge if hostpial length of stay was less than 72 hours)
Reported as:
Median · mg of protein/ln(mini-units/min)
Pyruvate Dehydrogenase Activity
mg of protein/ln(mini-units/min)ThiaminePlacebo
24 hours1.42 (1.05 to 2.07)1.53 (1.15 to 2.03)
72 hours (or at discharge if hostpial length of stay was less than 72 hours)1.87 (1.25 to 2.98)1.53 (1.13 to 2.20)
SecondaryNeurocognitive: Hopkins Verbal Learning Test - Total Recall

The Hopkins Verbal Learning Test-Revised (HVLT-R) Total Recall score is a measure of verbal learning and immediate memory. Participants are read a list of 12 words (from three semantic categories) and asked to recall as many words as possible across three consecutive learning trials. The Total Recall score is calculated as the sum of correctly recalled words across the three trials, yielding a possible range of 0 to 36, with higher scores indicating better verbal learning and memory performance. This score reflects both initial acquisition and short-term retention of verbal information and is commonly used to assess cognitive function in clinical research.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · scores on a scale
Neurocognitive: Hopkins Verbal Learning Test - Total Recall
scores on a scaleThiaminePlacebo
Neurocognitive: Hopkins Verbal Learning Test - Total Recall22 (16 to 26)23 (18 to 26)
SecondaryNeurocognitive: Hopkins Verbal Learning Test - Delayed Recall

The Hopkins Verbal Learning Test-Revised (HVLT-R) Delayed Recall score assesses retention of verbal information after a delay. Following completion of the three learning trials, participants are asked to recall the previously presented word list after a delay period (typically 20-25 minutes) without re-exposure to the words. The Delayed Recall score is calculated as the number of correctly recalled words, with a possible range of 0 to 12, where higher scores indicate better memory retention. This measure reflects the ability to consolidate and retrieve learned information over time and is commonly used to evaluate memory function in clinical and research settings.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · scores on a scale
Neurocognitive: Hopkins Verbal Learning Test - Delayed Recall
scores on a scaleThiaminePlacebo
Neurocognitive: Hopkins Verbal Learning Test - Delayed Recall8 (6 to 10)7 (4 to 9)
SecondaryNeurocognitive: Hopkins Verbal Learning Test - Retention

The Hopkins Verbal Learning Test-Revised (HVLT-R) Retention (%) score reflects the proportion of learned information that is retained over a delay. It is calculated as the ratio of the Delayed Recall score to the highest number of words recalled on any of the three immediate recall trials, multiplied by 100, yielding a percentage value. Scores typically range from 0% to 100%, with higher values indicating better retention of previously learned material. This measure provides an index of memory retention independent of initial learning performance.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · percentage
Neurocognitive: Hopkins Verbal Learning Test - Retention
percentageThiaminePlacebo
Neurocognitive: Hopkins Verbal Learning Test - Retention85 (74 to 95)76 (67 to 82)
SecondaryNeurocognitive: Hopkins Verbal Learning Test - Recognition Discrimination Index

The Hopkins Verbal Learning Test-Revised (HVLT-R) Recognition Discrimination Index assesses recognition memory by evaluating the ability to distinguish previously learned words from novel distractors. During the recognition phase, participants are presented with a list of target words and distractor words and asked to identify those that were previously learned. The Recognition Discrimination Index is calculated as the number of true positives (correctly identified target words) minus the number of false positives (incorrectly identified distractor words), yielding a score typically ranging from -12 to 12. Higher scores indicate better recognition accuracy and discrimination ability, reflecting the integrity of memory retrieval processes.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · scores on a scale
Neurocognitive: Hopkins Verbal Learning Test - Recognition Discrimination Index
scores on a scaleThiaminePlacebo
Neurocognitive: Hopkins Verbal Learning Test - Recognition Discrimination Index10 (8 to 11)11 (9 to 12)
SecondaryNeurocognitive: Brief Visuospatial Memory Test

The Brief Visuospatial Memory Test (BVMT) assesses visuospatial learning and memory. Participants are shown six geometric designs for a brief period and asked to reproduce them from memory across three learning trials. Performance is scored based on the accuracy and placement of each design, with a total recall score ranging from 0 to 36, where higher scores indicate better visuospatial memory. A delayed recall trial is administered after a delay to assess retention of visual information. This measure evaluates the ability to encode, store, and retrieve visuospatial material.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · scores on a scale
Neurocognitive: Brief Visuospatial Memory Test
scores on a scaleThiaminePlacebo
Neurocognitive: Brief Visuospatial Memory Test9 (6 to 13)12 (5 to 15)
SecondaryNeurocognitive: Trail Making Test - Test Part A

The Trail Making Test Part A (TMT-A) assesses visual attention, processing speed, and psychomotor function. Participants are instructed to connect numbered circles in sequential order as quickly as possible. The primary outcome is the time to completion, measured in seconds, with lower times indicating better performance. There is no fixed maximum score, although testing is typically discontinued at a predefined time limit (commonly 300 seconds).

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · seconds
Neurocognitive: Trail Making Test - Test Part A
secondsThiaminePlacebo
Neurocognitive: Trail Making Test - Test Part A38 (36 to 58)29 (22 to 48)
SecondaryNeurocognitive: Trail Making Test - Test Part B

The Trail Making Test Part B (TMT-B) assesses executive function, including cognitive flexibility and set-shifting, in addition to processing speed. Participants are required to alternate between numbers and letters in sequence (e.g., 1-A-2-B) as quickly as possible. The primary outcome is the time to completion, measured in seconds, with lower times indicating better performance. As with TMT-A, there is no fixed maximum score, and testing is typically discontinued at a predefined time limit (commonly 300 seconds).

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · seconds
Neurocognitive: Trail Making Test - Test Part B
secondsThiaminePlacebo
Neurocognitive: Trail Making Test - Test Part B96 (68 to 142)84 (54 to 162)
SecondaryNeurocognitive: WAIS-IV Digit Span

The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Digit Span subtest assesses attention, working memory, and concentration. Participants are asked to repeat sequences of numbers in forward order (Digit Span Forward), reverse order (Digit Span Backward), and ascending order (Digit Span Sequencing). Scores are based on the total number of correctly recalled sequences, with higher scores indicating better attention and working memory capacity. The total score ranges from 0 to 48.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · scores on a scale
Neurocognitive: WAIS-IV Digit Span
scores on a scaleThiaminePlacebo
Neurocognitive: WAIS-IV Digit Span24 (18 to 28)23 (20 to 28)
SecondaryNeurocognitive: Test of Verbal Fluency and Animal Naming

The Animal Naming test is a measure of semantic verbal fluency and executive function. Participants are asked to name as many animals as possible within a fixed time period. The score is the total number of unique, correct animal names generated, with higher scores indicating better semantic memory retrieval and executive functioning. Scores range from 0 with no fixed upper limit.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · correct responses per minute
Neurocognitive: Test of Verbal Fluency and Animal Naming
correct responses per minuteThiaminePlacebo
Neurocognitive: Test of Verbal Fluency and Animal Naming54 (37 to 60)55 (42 to 65)
SecondaryNeurocognitive: Test of Premorbid Functioning

The Test of Premorbid Functioning (TOPF) estimates an individual's baseline cognitive ability prior to illness or injury. Participants are asked to read aloud a list of irregularly spelled words, and performance is scored based on correct pronunciation. Scores are used to estimate premorbid intellectual functioning. Scores range from 0 to 70, with higher scores indicating higher estimated premorbid functioning. This measure helps contextualize current cognitive performance relative to expected baseline levels.

Time frame:
At hospital discharge, median of 4 days
Reported as:
Median · scores on a scale
Neurocognitive: Test of Premorbid Functioning
scores on a scaleThiaminePlacebo
Neurocognitive: Test of Premorbid Functioning42 (25 to 56)42 (32 to 55)

Adverse events

Collected over from enrollment until hospital discharge, median of 4 days. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Thiamine3/52 (5.8%)0/52 (0%)0/52 (0%)
Placebo1/48 (2.1%)0/48 (0%)0/48 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)ThiaminePlaceboTotal
Median51 (30 to 64)43 (27 to 57)46 (29 to 60)
Sex: Female, Male
Sex: Female, Male(Participants)ThiaminePlaceboTotal
Female222648
Male302252
Race (NIH/OMB)
Race (NIH/OMB)(Participants)ThiaminePlaceboTotal
American Indian or Alaska Native011
Asian134
Native Hawaiian or Other Pacific Islander000
Black or African American201131
White272754
More than one race224
Unknown or Not Reported246
Region of Enrollment
Region of Enrollment(Participants)ThiaminePlaceboTotal
United States5248100
Diabetes Mellitus Type
Diabetes Mellitus Type(Participants)ThiaminePlaceboTotal
Type 1 diabetes mellitus373673
Type 2 diabetes mellitus151227
DKA History
DKA History(Participants)ThiaminePlaceboTotal
None272350
Previous DKA202444
Unknown516
Prior Insulin Use
Prior Insulin Use(Participants)ThiaminePlaceboTotal
Yes383573
No141327
Insulin Pump Use
Insulin Pump Use(Participants)ThiaminePlaceboTotal
Yes91019
No433881

8 further baseline measures are reported on the registry.

08

Study locations

1 site
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
09

References and documents

Publications

  • Vine J, Mehta S, Balaji L, Berg KM, Berlin N, Liu X, Ngo L, Shea M, Moskowitz A, Donnino MW, Grossestreuer AV. Thiamine as adjunctive therapy for diabetic ketoacidosis (DKAT) trial protocol and statistical analysis plan: a prospective, single-centre, double-blind, randomised, placebo-controlled clinical trial in the USA. BMJ Open. 2024 Feb 29;14(2):e077586. doi: 10.1136/bmjopen-2023-077586. PubMed 38423765 ↗

Study documents

  • Protocol and statistical analysis plan · Apr 16, 2026

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03717896
Lead sponsor
Beth Israel Deaconess Medical Center
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Responsible party
Michael Donnino (Associate Professor of Medicine and Emergency Medicine, Beth Israel Deaconess Medical Center) — Principal investigator
First posted
Oct 24, 2018
Start date
Nov 21, 2018
Primary completion
Sep 30, 2024
Completion
Oct 1, 2024
Results posted
Jun 23, 2026
Last update
Jun 23, 2026

Study contacts

Michael Donnino, MD
principal investigator · Beth Israel Deaconess Medical Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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