The potential role of benfotiamine in the treatment of diabetic cardiac autonomic neuropathy
Keywords:type 2 diabetes mellitus, cardiac autonomic neuropathy, benfotiamine, heart rate variability, corrected QT interval, spatial QRS-T angle
Background. Cardiac autonomic neuropathy is a serious complication of diabetes mellitus that is strongly associated with approximately five-fold increased risk of cardiovascular mortality. Cardiac autonomic neuropathy manifests itself in a spectrum of things, ranging from resting tachycardia and fixed heart rate to the development of silent myocardial infarction. The significance of diabetic cardiac autonomic neuropathy has not been fully appreciated and there is no unified treatment algorithm. The purpose was to investigate the effects of benfotiamine on the heart rate variability, the corrected QT interval, QT dispersion and spatial QRS-T angle in patients with type 2 diabetes mellitus and cardiac autonomic neuropathy. Materials and methods. Thirty-two patients with type 2 diabetes mellitus and definite stage of cardiac autonomic neuropathy were allocated into two treatment groups: control (n = 15) received traditional antihyperglycaemic therapy; group 2 (n = 17) — benfotiamine 300 mg/day for three months in addition to standard treatment. Results. It was found that benfotiamine contributed to an increase in the sum of the squares of differences between adjacent normal-to-normal intervals, pNN50 (Δ% = +45.90 ± 7.91 %, p < 0.05), high-frequency component of heart rate variability during the active (Δ% = +25.80 ± 5.58 %, p < 0.05) and passive periods of the day (Δ% = +21.10 ± 4.17 %, p < 0.05), led to a decrease in the corrected QT interval (Δ% = –7.30 ± 1.36 %, p < 0.01), QT dispersion (Δ% = –27.7 ± 9.0 %, p < 0.01) and spatial QRS-T angle (Δ% = –24.4 ± 10.2 %, p < 0.01). Conclusions. The positive influence of benfotiamine suggests the feasibility of its administration to patients with type 2 diabetes mellitus and definite stage of cardiac autonomic neuropathy.
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