Alpha-Lipoic Acid May Improve Symptomatic Diabetic Polyneuropathy

Tang, Junger; Wingerchuk, Dean M.; Crum, Brian A.; Rubin, Devon I.; Demaerschalk, Bart M.

doi:10.1097/01.nrl.0000263703.78318.2b

Cited by 28 publications

(27 citation statements)

References 5 publications

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“…In line with this observation, clinical results have been contradictory for antioxidants as alpha lipoic acid, ranging from little benefit [29,30] to interesting advantages [31,32] .…”

Section: Oxidative and Nitrosative Stressmentioning

confidence: 93%

Diabetic neuropathic pain: Physiopathology and treatment

Schreiber

Nones

Reis

et al. 2015

WJD

355

267

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Diabetic neuropathy is a common complication of both type 1 and type 2 diabetes, which affects over 90% of the diabetic patients. Although pain is one of the main symptoms of diabetic neuropathy, its pathophysiological mechanisms are not yet fully known. It is widely accepted that the toxic effects of hyperglycemia play an important role in the development of this complication, but several other hypotheses have been postulated. The management of diabetic neuropathic pain consists basically in excluding other causes of painful peripheral neuropathy, improving glycemic control as a prophylactic therapy and using medications to alleviate pain. First line drugs for pain relief include anticonvulsants, such as pregabalin and gabapentin and antidepressants, especially those that act to inhibit the reuptake of serotonin and noradrenaline. In addition, there is experimental and clinical evidence that opioids can be helpful in pain control, mainly if associated with first line drugs. Other agents, including for topical application, such as capsaicin cream and lidocaine patches, have also been proposed to be useful as adjuvants in the control of diabetic neuropathic pain, but the clinical evidence is insufficient to support their use. In conclusion, a better understanding of the mechanisms underlying diabetic neuropathic pain will contribute to the search of new therapies, but also to the improvement of the guidelines to optimize pain control with the drugs currently available.

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“…In line with this observation, clinical results have been contradictory for antioxidants as alpha lipoic acid, ranging from little benefit [29,30] to interesting advantages [31,32] .…”

Section: Oxidative and Nitrosative Stressmentioning

confidence: 93%

Diabetic neuropathic pain: Physiopathology and treatment

Schreiber

Nones

Reis

et al. 2015

WJD

355

267

View full text Add to dashboard Cite

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“…[6] Treating neuropathy is a difficult task for the physician and most of the conventional pain medications primarily mask symptoms. [78] and have significant side effects and addiction profiles. In the realm of physical medicine acupuncture, magnetic therapy, yoga have been found to provide benefit.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the efficacy of pulsed electromagnetic field in the management of patients with diabetic polyneuropathy

Graak¹,

Chaudhary²,

Bal³

et al. 2009

Int J Diab Dev Ctries

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AIM:The study was carried out to evaluate and compare the effect of low power, low frequency pulsed electromagnetic field (PEMF) of 600 and 800 Hz, respectively, in management of patients with diabetic polyneuropathy.SETTINGS AND DESIGNS:The study was a randomized controlled trial performed in Guru Nanak Dev University and Medical College, Amritsar, India with different subject experimental design.MATERIALS AND METHODS:Thirty subjects within an age group of 40–68 years with diabetic polyneuropathy stages N1a, N1b, N2a were randomly allocated to groups 1, 2, 3 with 10 subjects in each. Group 1 and 2 were treated with low power 600 and 800-Hz PEMF for 30 min for 12 consecutive days. Group 3 served as control on usual medical treatment of diabetic polyneuropathy (DPN). The subjects with neuropathy due to any cause other than diabetes were excluded. The pain and motor nerve conduction parameters (distal latency, amplitude, nerve conduction velocity) were assessed before and after treatment.STATISTICAL ANALYSIS:Related t-test and unrelated t-test were used for data analysis.RESULTS:Significant reduction in pain and statistically significant (P<0.05) improvement in distal latency and nerve conduction velocity were seen in experimental group 1 and 2.CONCLUSIONS:Low-frequency PEMF can be used as an adjunct in reducing neuropathic pain as well as for retarding the progression of neuropathy in a short span of time.

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“…Total scores can range from 0 to 14.64; a peak score suggests the continuous presence of severe discomfort in all four symptom domains. Beyond statistically significant changes in the measure, a clinically meaningful improvement in TSS was defined as a mean difference of at least 1.83 points 34,38. Several secondary measures of patient experience were also reported, including the four individual components of the TSS, the Number-Severity-Change (NSC) metric, the Global Assessment of Efficacy (GAE), and the Hamburg Pain Adjective List (HPAL).…”

Section: Resultsmentioning

confidence: 99%

Critical appraisal of the use of alpha lipoic acid (thioctic acid) in the treatment of symptomatic diabetic polyneuropathy

McIlduff¹,

Rutkove

2011

TCRM

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BackgroundThe most common of the neuropathies associated with diabetes mellitus, diabetic sensorimotor polyneuropathy (DSPN) is a syndrome of diffuse, length-dependent, symmetric nerve dysfunction. The condition is linked with substantial morbidity, frequent healthcare utilization, and compromised quality of life due to related discomfort. Correspondingly, antidepressants, anticonvulsants, and opioids are regularly prescribed with the goal of pain control. However, the agents rarely provide complete pain relief and fail to address progression of the disorder. Whereas strict blood glucose control can slow the onset and worsening of DSPN, near-normoglycemia is not easily attainable. Evidence implicating oxidative processes in the pathogenesis of DSPN offers one potentially important therapeutic avenue. Due to its properties as a potent antioxidant, alpha lipoic acid (ALA) could mitigate the development of DSPN and attenuate resultant symptoms and signs. Approved for treatment of DSPN in Germany, the agent is not more widely used due to uncertainty about its efficacy and reported adverse effects. Here we review the effectiveness and tolerability of ALA in the treatment of symptomatic DSPN.MethodsThe MEDLINE, EMBASE, and Cochrane Library databases were searched for English-language literature on the topic. Randomized, blinded studies comparing parenteral and oral ALA with placebo in the treatment of peripheral neuropathy in diabetic adults were selected. Analysis included studies with a level of evidence of at least 2b.ResultsThe current appraisal summarizes data from 1160 participants in the ALADIN, SYDNEY, ORPIL, SYDNEY 2, and ALADIN III trials. In four of the studies, ALA provided significant improvement in manifestations of DSPN.ConclusionTreatment with ALA 600 mg iv daily for 3 weeks represents a well-tolerated and effective therapy for DSPN. An oral dose of 600 mg daily administered for up to 5 weeks could offer benefits in symptoms and signs of DSPN without significant side effects.

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Alpha-Lipoic Acid May Improve Symptomatic Diabetic Polyneuropathy

Cited by 28 publications

References 5 publications

Diabetic neuropathic pain: Physiopathology and treatment

Diabetic neuropathic pain: Physiopathology and treatment

Evaluation of the efficacy of pulsed electromagnetic field in the management of patients with diabetic polyneuropathy

Critical appraisal of the use of alpha lipoic acid (thioctic acid) in the treatment of symptomatic diabetic polyneuropathy

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