Diet gun

In the recent article published on February 1, 2026 in MDPI entitled Thiamine Deficiency in Diabetes: Implications for Diabetic Ketoacidosis, we see that vitamin B1 (thiamine) deficiency can create many complications in people with diabetes, complications that do not have a good prognosis.

Diabetic ketoacidosis is a life-threatening complication of diabetes.

Thiamine deficiency is particularly common in diabetes, with plasma concentrations reduced by about 75% compared to healthy people.

In the case of diabetic ketoacidosis, 25-35% of patients have thiamine deficiency, which often worsens during insulin therapy.

This deficiency causes a greater accumulation of pyruvic acid with conversion to lactic acid (resulting in lactic acidosis), a nearly 50% reduction in ATP production, and a decrease in NADPH production, resulting in increased oxidative stress.

The result of all this is persistent metabolic acidosis despite standard treatment, myocardial dysfunction, neurological damage, and prolonged recovery times.

Studies show that thiamine supplementation improves lactic acidosis and normalizes its levels, significantly improving oxygen consumption in mitochondrial cells (which is reduced in a state of diabetic ketoacidosis).

However, thiamine supplementation is inadequate in the management of diabetic ketoacidosis, with only about a quarter of patients with diabetic ketoacidosis receiving thiamine !!

High doses of thiamine in hyperglycemic individuals also improve glucose tolerance, as well as blood pressure.

Thiamine is an extremely safe vitamin, with minimal adverse effects even at high doses, mainly nausea and minor allergic reactions.

Given the high incidence of thiamine deficiency in diabetic ketoacidosis in individuals with diabetes, the low cost of the vitamin as a supplement and the almost nonexistent adverse side effects it has, it should always be administered as a supplement to individuals with diabetic ketoacidosis, either by injection in the hospital or clinic and in the form of home supplements as a preventative measure.

The following foods contain thiamine (vitamin B1), and their consumption may help prevent diabetic ketoacidosis:

whole grains, legumes, meat, beef liver, fish and especially salmon, hazelnuts, almonds.