Alpha lipoic acid and diabetes mellitus: potential effects on peripheral neuropathy and different metabolic parameters

ABSTRACT

Introduction: Alpha lipoic acid (ALA) is an antioxidant used in the treatment of neuro-inflammation, diabetes and diabetic nephropathy. The current study aiming to gauge the effect of oral ALA on diabetic peripheral neuropathy, glycemic control, LDL-C, and HDL-C. Methods: This is a prospective, interventional study carried out on patients with type 2 diabetes mellitus (DM) who were following at the outpatient internal medicine & diabetes clinics at Benha University Hospital. Treatment with ALA for 3 months was given to patient with diabetic peripheral neuropathy. Data in the form of age, sex, body mass index (BMI), duration & treatment of DM, manifestations of peripheral neuropathy were collected. LDL-C, HDL-C, HbA1c, TSH, ALT, AST were measured before and after intervention. Peripheral neuropathy symptoms, nerve conduction velocities, cardiovascular (CV) tests of autonomic neuropathy, and cross-section area of the posterior tibial nerve were performed before and after treatment intervention. Results: 90 adult diabetic patients were recruited in the study, 42.2% were females and 57.8% were males with a median age of 50–60.3 years (IQR = 52). A statistically significant improvements of neuropathic symptoms, nerve conduction velocity, and cardiovascular autonomic neuropathy were noted after 3 months of administration of ALA (p ˂0.001). However, the cross-section area of the posterior tibial nerve at baseline and after treatment did not change significantly (p value of 0.84). There was a significant improvement in the BMI, HDL-C, LDL-C, HbA1c (p ˂ 0.001). Conclusion: Oral treatment with ALA might cause ameliorations of peripheral neuropathy, HbA1c, and LDL-C & HDL-C levels in diabetic patients. Our result failed to proof effect of ALA on nerve cross-section area. The global data encourage further studies with this medication as an ancillary treatment of DM2.

Clinical trial registration: It was registered in clinical trial website; ClinicalTrials.gov Identifier (NCT number): NCT04322240.

KEYWORDS:

• Alpha lipoic acid
• diabetic peripheral neuropathy
• diabetes mellitus

Acknowledgments

We would like to thank all the nurses, and the patients who contributed in this study. We would like to express our very great appreciation to Clinical Pathology Department, Benha Faculty of Medicine, for performing laboratory investigations to our patients & Rheumatology Departments, Benha Faculty of Medicine, for sharing in nerve conduction velocities and ultrasonography on nerves.

Disclosure statement

All author(s) stated that they do not have any conflict of interests.

Sources of funding

This study did not obtain any specific contribution from funding agencies in the commercial, public, or not-for-profit sectors.

Ethical approval

The study was approved by the Ethics Committee of Benha faculty of medicine, Benha University with written informed consent was obtained from all participants.

Additional information

Notes on contributors

Ayman M Elbadawy

Ayman M Elbadawy was post-graduated by Medical Doctora in 2006. He is working as assistant professor of internal medicine, in Benha Univeristy. He is interested in internal medicine, gastro-enterology, and hepatology with clinical experience since 1996 in clinical cases management and teaching in Faculty of medicine, Benha Univeristy.

Rasha O. Abd Elmoniem

Rasha O. Abd Elmoniem was post-graduated by Medical Doctora in 2016. she is working as lecturer of internal medicine, in Benha Univeristy. She is interested in internal medicine,and endocrine with clinical experience since 2005 in clinical cases management and teaching in Faculty of medicine, Benha Univeristy.

Amira M. Elsayed

Amira M. Elsayed is originally from Benha city, Qalubia governerate where she attended faculty of medicine, Benha University for her undergraduate degrees. She was graduated in M.B.B.Ch in medicine and Surgey in 2000 then as trainee till 2001 in Benha University Hospitals. She was assigned for work in Egyptian ministry of Health for 2 years as general practational, then she joined again Benha University Hospitals where postgraduated by Master degree & Medical Doctor in 2006 & 2011, respectively. Till now, she is working as assistant professor of internal medicine, endocrinology & diabetes. She spent seven years abroad in gulf area working as physician in internal medicine, endocrine, and diabetes where she experiences in management on general emergency cases, internal medicine, endocrinology and diabetes. In 2019, she got Specialty Certificate Examinations (SCE in endocrinology & diabetes) from Royal Colleges of Physicians of the United Kingdom. she focuses on diabetes and endocrinology cases and researches. You can follow her work here [[email protected]].