Oral Alpha Lipoic Acid Treatment for Symptomatic Diabetic Peripheral Neuropathy: A Randomized Double-Blinded Placebo-Controlled Study

Abstract

Background: Alpha-lipoic acid (ALA) was tried in treatment of diabetic peripheral neuropathy (DPN) using different routes, doses and treatment durations. The aim of this work is to assess the efficacy of oral 600mg ALA twice daily over 6 months in treatment of patients with DPN. Methods: This is a prospective, single-center, double-blinded, placebo-controlled study conducted at the outpatient clinics of Mansoura Specialized Hospital, Mansoura University. A total of 200 patients with DPN were randomly assigned to add on treatment with either oral 600mg twice daily ALA (n=100) or placebo (n=100) for 6 months. Treatment outcome was assessed using vibration perception threshold (VPT), neurological symptom score (NSS), neurological disability score (NDS), and visual analog scale (VAS) for pain at baseline and at each visit (1, 3 and 6 months) after the start of treatment. Results: Comparison between the study groups regarding the baseline data revealed no statistically significant differences. In respect to the outcome parameters, no significant differences were found between the studied groups at baseline. However, in subsequent visits, ALA treated patients had significantly better resultsregarding almost all the outcome parameters (NSS, NDS, VAS, VPT). Mild nausea was reported in 6 patients. None of the studied patients discontinued treatment. Conclusions: Oral 600mg ALA twice daily treatment for DPN over 6 months is effective, safe and tolerable.

Alpha lipoic acid attenuates evoked and spontaneous pain following surgical skin incision in rats

“…Importantly, ALA has been recognized as a therapeutic option for patients with diabetic neuropathy. It has been shown that chronic application of ALA during a period of 6 months in patients suffering from diabetic neuropathy is effective, safe, and well tolerated [ 6 ]. Furthermore, ALA has also been shown to reduce pain in patients suffering from chemotherapy-induced peripheral neuropathy [ 7 ].…”

Honokiol attenuates high glucose‐induced peripheral neuropathy via inhibiting ferroptosis and activating AMPK/SIRT1/PGC‐1α pathway in Schwann cells

“…More importantly, we found that chronic administration of HNK ameliorated peripheral nerve dysfunction in STZ‐induced diabetic rats, and the protective effects of HNK on Schwann cells and nerve tissue were mainly mediated by activation of AMPK/SIRT1/PGC‐1α signaling pathway. ALA has been widely accepted as a therapeutic agent for DPN (El‐Nahas et al, 2020). In this study, we used ALA as a positive control in the in vivo experiments.…”

Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations

“…Moreover, treatment for 5 weeks and 6 months using -lipoic acid 600 mg QD and BID orally, respectively, reduced the main symptoms of DSPN including pain, paresthesias, and numbness 82,[85][86][87][88][89][90][91][92][93][94] . In the NATHAN 1 trial, neuropathic deficits were improved after 4 years in patients with mild to moderate largely asymptomatic DSPN 86 .…”