Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Benfotiamine is a lipid-soluble derivative of vitamin B1 (thiamine) and has been investigated for its potential role in treating or supporting diabetic retinopathy. The rationale comes from benfotiamine’s ability to inhibit several damaging biochemical pathways activated by hyperglycemia, particularly the formation of advanced glycation end products (AGEs), protein kinase C activation, and hexosamine pathway flux. These mechanisms are implicated in the pathogenesis of diabetic microvascular complications, including retinopathy.

Preclinical studies, especially in animal models, have shown that benfotiamine supplementation can reduce retinal oxidative stress, inflammation, and vascular damage associated with diabetes. For example, research published in Diabetologia (Hammes et al., 2003) demonstrated that benfotiamine prevented the development of experimental diabetic retinopathy in rats by blocking these metabolic pathways.

However, clinical evidence in humans is limited. Some small studies have shown potential benefit of benfotiamine in reducing markers of diabetic complications, but robust, well-powered clinical trials specifically targeting diabetic retinopathy are lacking. A few pilot studies suggest possible improvements in early neuropathic or inflammatory changes, but do not conclusively establish efficacy for retinopathy.

In summary, while there is a sound mechanistic basis and supportive evidence from animal studies for benfotiamine’s use in diabetic retinopathy, human clinical evidence is currently insufficient and inconclusive. Thus, the scientific rationale exists, but the evidence supporting its clinical use is still considered preliminary (evidence rating: 2/5).

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