Efficacy of α-lipoic acid in diabetic neuropathy.
BACKGROUND
Neuropathy is a serious complication of diabetes. Its management focuses on glycaemic control, multifactorial cardiovascular risk intervention, pathogenesis-oriented therapy, and analgesics where needed.


METHODS
The objective of this review is assessment of efficacy and safety of α lipoic acid (ALA, also thioctic acid) in pathogenesis-oriented treatment of diabetic neuropathy. The mechanisms of action of ALA in experimental diabetic neuropathy include reduction of oxidative stress along with improvement in nerve blood flow, nerve conduction velocity, and several other measures of nerve function. There is ample evidence from randomised, double-blind, placebo-controlled clinical trials and meta-analyses, suggesting that ALA is efficacious and safe for the diabetic neuropathy, accomplishing clinically meaningful improvements.


CONCLUSIONS
ALA is a valuable therapeutic option for diabetic neuropathy. When compared with currently licensed analgesic drugs, it is better tolerated, has a more rapid onset of action, and improves paraesthesiae, numbness, sensory deficits, and muscle strength in addition to neuropathic pain. In clinical practice, ALA may be chosen in patients with early neuropathic deficits and symptoms, in whom clinical improvement is more likely. ALA should also be considered when comorbidities render other analgesics less appropriate or in the presence of cardiovascular autonomic neuropathy.
Democritus University of Thrace, Second Department of Internal Medicine , Alexandroupolis , Greece.
Nikolaos
N
Papanas
Dan
D
Ziegler
D000975:Antioxidants / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000473:pathology; D003929:Diabetic Neuropathies / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006207:Half-Life; D006801:Humans; D017382:Reactive Oxygen Species / Q000737:chemistry / Q000378:metabolism; D008063:Thioctic Acid / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use*
D000975:Antioxidants; D017382:Reactive Oxygen Species; D008063:Thioctic Acid
diabetes mellitus; diabetic neuropathy; efficacy; oxidative stress; thioctic acid; treatment