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Status unknownNCT04053621Updated Oct 22, 2020

Co-administration of Thiamine Pyrophosphate and Metformin in Type 2 Diabetes

An interventional study of Thiamine pyrophosphate and Placebo in Diabetes Mellitus, Type 2, sponsored by Laboratorios Manuell SA. Status unknown at 1 site in Mexico. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-10-22.

Sponsored by Laboratorios Manuell SA · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Oct 2020), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
92
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

Chronic non-infectious diseases have a bigger impact and a higher prevalence every day world-wide. Among them, diabetes stands out being the number one cause of death from degenerative chronic illness in Mexico. Diabetes not only affects quality of life, it can also lead to severe complications that have a great economic impact as well as a health impact on the patient and their family. Some of the complications include liver failure and hypertension. This whole problem can be dated back to an initial hyperglycemic state that when left untreated further develops into insulin resistance, chronic inflammation, metabolic syndrome and diabetes. The purpose of this study is to stop this chain reaction that starts with every hyperglycemic patient by adding thiamine pyrophosphate to the treatment plan of patients diagnosed with type 2 diabetes that are poorly managed with metformin monotherapy. Thiamine pyrophosphate is a form of B1 vitamin that plays an important role as a coenzyme in multiple metabolic routes including the link between glycolysis and Krebs cycle, fatty acids metabolism and branched-chain amino acid metabolism. By doing so, these pathways improve their function and efficiency and thereby utilize plasma glucose. This in turn, decreases the formation of advanced glycation end products (AGEs) which prevents the formation of reactive oxygen and nitrogen species, ultimately there is also an anti-oxidative mechanism involved that improves the inflammatory state the patient is living with. Our hypothesis is that by adding thiamine pyrophosphate to the treatment of patients taking metformin, there will be important progress regarding the inflammatory and metabolic control of patients with type 2 diabetes.

The study will have a duration of approximately 4 months after the total sample is recruited. During this time, subjects will first be examined to determine their eligibility according to the pre-established criteria, in case of inclusion in the study they will sign an informed consent after reading it thoroughly and having answered all their questions. Baseline labs will be taken for every subject for future comparison. They will then be randomized into two parallel groups: an experimental group that will receive weekly infusions of saline infused with 1 gram of thiamine pyrophosphate or a placebo group that will also receive weekly infusions of pure saline. The patients as well as the doctors treating them will be blinded to the assignment of either group. This model will be carried out for a duration of 12 weeks total, during which every patient will continue their metformin treatment with their tolerated dose. There will be verification of treatment adherence by counting the metformin pills during every weekly visit. For the assessment of dependent variables there will be a visit every month with a blinded doctor. These visits will be for: physical and clinical evaluation, evaluation of adverse events, evaluation of treatment adherence and a heart rate variability study. The first and third months a questionnaire about lifestyle will be added to the visit schedule. On the third month, final lab tests will be performed. Finally, one month after completing the treatment, a final visit will be scheduled for a clinical and physical evaluation to make sure there are no problems.

02

Conditions studied

  • Diabetes Mellitus, Type 2

Keywords

  • metformin
  • thiamine pyrophosphate
  • B1 vitamin
  • type 2 diabetes mellitus
  • metabolic pathways
03

In context

Diabetes Mellitus

10,925 studies on the registry are indexed under Diabetes Mellitus; 1,319 are open to participants now.

This study's planned enrollment of 92 is above the median of 80 across 8,367 interventional studies indexed under Diabetes Mellitus.

Browse Diabetes Mellitus studies →

Lead sponsor

This is the only study on the registry with Laboratorios Manuell SA as lead sponsor.

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

  • signed informed consent
  • diagnosed type 2 diabetes mellitus
  • HbA1c between 7.5 and 11%
  • monotherapy treatment with metformin at tolerated successful dose

Exclusion criteria

Exclusion Criteria:

  • glomerular filtration rate \<60 ml/min/1.73m2
  • cardiac o respiratory insufficiency
  • liver enzymes 3 times higher than normal parameters
  • known allergy to metformin or thiamine pyrophosphate
  • pregnancy, lactation or fertile age without a contraceptive method
  • participation in another study in the last 6 months
  • programmed surgery for the next 4 months
  • treatment with any other hypoglycemic agents
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
92 participants (estimated)

Study arms

  • Experimental
    Experimental group

    Metformin at patient´s tolerated oral dose (maximum of 2550 mg per day) and thiamine pyrophosphate (weekly dose of 1 gram administered by IV: 25 ml of thiamine pyrophosphate + 250 ml saline solution at a 60-80 drops/minute rate). Total duration of 12 weeks.

    Dietary Supplement: Thiamine pyrophosphate · Drug: Metformin

  • Placebo comparator
    Placebo group

    Metformin at patient´s tolerated oral dose (maximum of 2550 mg per day) and weekly administration of 275 ml of saline solution at a 60-80 drops/minute rate). Total duration of 12 weeks.

    Other: Placebo · Drug: Metformin

Interventions

  • Dietary supplementThiamine pyrophosphate

    12 weeks of weekly dose of 1 gram of thiamine pyrophosphate administered in an intravenous manner with saline solution

    Also known as: Cocarboxylase

  • OtherPlacebo

    12 weeks of weekly dose of 275 ml of saline solution administered in an intravenous manner

  • DrugMetformin

    All participants will continue taking metformin in their previous established tolerated dose for the duration of the study

06

What researchers measure

Primary outcomes

  1. hemoglobin A1c

    percentage

    Time frame: Change from baseline at 3 months

Secondary outcomes

  1. fasting plasma glucose

    mg/dl

    Time frame: Change from baseline at 3 months

  2. Lipids profile

    Concentration of total cholesterol, HDL, LDL and triglycerides (mg/dl)

    Time frame: Change from baseline at 3 months

  3. inflammation markers

    Concentration of PCR, IL-6, TNF-alpha, nitric oxyde, superoxide dismutase, free fatty acids, catalase

    Time frame: Change from baseline at 3 months

  4. Lifestyle measurement

    IMEVID questionnaire (instrumento para medir el estilo de vida en diabéticos). Total scores are reported from 0-100. Higher scores are associated with a better lifestyle, \>75 quartile is considered a good score.

    Time frame: Change from baseline at 3 months

  5. heart rate variability

    measured in milliseconds

    Time frame: Change from baseline at 3 months

  6. arterial elasticity

    Using the HDI/PulseWave instrument

    Time frame: Change from baseline at 3 months

07

Study locations

1 site
  • Centro Especializado en Diabetes, Obesidad, Prevención y Enfermedades Cardiovasculares, S.C.
    Mexico City, Cdmx 11650, Mexico
    • Melchor Alpizar, MD, PhD · Contact · malpizar@cedopec.com · 52824343
    • Tamara D Frydman, MD · Sub investigator
    • Jessica Duran Trejo, MD · Sub investigator
    • Fernanda Alpizar Sanchez, MD · Sub investigator
    • Elio Noguera Suarez, MD · Sub investigator
    • Carlos Jimenez Collado, MD · Sub investigator
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References and documents

Publications

  • Alaei Shahmiri F, Soares MJ, Zhao Y, Sherriff J. High-dose thiamine supplementation improves glucose tolerance in hyperglycemic individuals: a randomized, double-blind cross-over trial. Eur J Nutr. 2013 Oct;52(7):1821-4. doi: 10.1007/s00394-013-0534-6. Epub 2013 May 29. PubMed 23715873 ↗
  • Al-Daghri NM, Alharbi M, Wani K, Abd-Alrahman SH, Sheshah E, Alokail MS. Biochemical changes correlated with blood thiamine and its phosphate esters levels in patients with diabetes type 1 (DMT1). Int J Clin Exp Pathol. 2015 Oct 1;8(10):13483-8. eCollection 2015. PubMed 26722561 ↗
  • Benítez-Rodríguez MT. Actualidades del Pirofosfato de Tiamina o Carboxilasa. 1st ed. México: Litográfica Santander; 2013.
  • Elksnis A, Martinell M, Eriksson O, Espes D. Heterogeneity of Metabolic Defects in Type 2 Diabetes and Its Relation to Reactive Oxygen Species and Alterations in Beta-Cell Mass. Front Physiol. 2019 Feb 13;10:107. doi: 10.3389/fphys.2019.00107. eCollection 2019. PubMed 30837889 ↗
  • Lopez-Carmona JM, Rodriguez-Moctezuma JR, Ariza-Andraca CR, Martinez-Bermudez M. [Lifestyle and metabolic control in patients with type 2 diabetes mellitus. Construct validation of IMEVID questionnaire]. Aten Primaria. 2004 Jan;33(1):20-7. doi: 10.1016/s0212-6567(04)78873-3. Spanish. PubMed 14746741 ↗
  • Pacal L, Kuricova K, Kankova K. Evidence for altered thiamine metabolism in diabetes: Is there a potential to oppose gluco- and lipotoxicity by rational supplementation? World J Diabetes. 2014 Jun 15;5(3):288-95. doi: 10.4239/wjd.v5.i3.288. PubMed 24936250 ↗
  • Shapoval GS, Babii LV, Kruglyak OS, Vovk AI. Antioxidant activity of thiamine and its structural analogs in reactions with electrochemically generated hydroxyl radicals and hydrogen peroxide. Theor Exp Chem. 2011; 47, 1: 55 - 60.

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 22, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04053621
Lead sponsor
Laboratorios Manuell SA
Collaborators
Universidad Nacional Autonoma de Mexico
Responsible party
Dr. Melchor Alpízar Salazar (Principal investigator, Laboratorios Manuell SA) — Principal investigator
First posted
Aug 12, 2019
Start date
Jan 2021 (estimated)
Primary completion
Jan 2022 (estimated)
Completion
Mar 2022 (estimated)
Last update
Oct 22, 2020

Study contacts

Melchor Alpizar, MD, PhD
Contact
malpizar@cedopec.com
52824343 ext. 201
Melchor Alpizar, MD, PhD
principal investigator · Centro Especializado en Diabetes, Obesidad, Prevención y Enfermedades Cardiovasculares, S.C.

Oversight

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

Not currently enrolling

This study is status unknown, as verified in Oct 2020. You cannot join it, but the record below documents what was studied.

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