Treatment with a combination of four nutrients, i.e. R-a-lipoic acid, acetyl-L-carnitine, nicotinamide and biotin, just as with pioglitazone, significantly improves glucose tolerance, insulin release, plasma NEFA, skeletal muscle mitochondrial biogenesis and oxidative stress in Goto -Kakizaki (GK) rats. However, it is not known whether treatment with these nutrients can improve mitochondrial function and reduce oxidative stress in GK rats. The effects of a combination of these four nutrients on mitochondrial function, oxidative stress and apoptosis in GK rat liver were investigated. Livers of untreated GK rats showed (1) abnormal changes in the activities of mitochondrial complexes (decreases in I, III and IV and increases in II and V), (2) increases in protein oxidation, (3) decreases in antioxidant enzymes (superoxide dismutase, glutathione S-transferase, NADH-quinone oxidoreductase-1), (4) a decrease in total antioxidant capacity but increases in reduced glutathione level and glyceraldehyde 3-phosphate dehydrogenase expression and (5) significant increases in apoptosis biomarkers, including expression of p21 and p53. A 3-month treatment with the four nutrients significantly improved most of these abnormalities in GK rats, and the effects of the nutrient combination were greater than those of pioglitazone for most of these indices. These results suggest that dietary supplementation with nutrients that are thought to influence mitochondrial function may be an effective strategy for improving liver dysfunction in GK diabetic rats.Key words: R-a-Lipoic acid: Acetyl-L-carnitine: Nicotinamide: Biotin: Oxidative damage: Phase II enzymes: Apoptosis Type 2 (non-insulin-dependent) diabetes mellitus is one of the most common metabolic diseases in humans, affecting about 3 % of the human population. Clinically, it is rather a group of related diseases, characterised by chronic hyperglycaemic levels, due to an impairment in the balance among the three processes of b-cell secretion of insulin, peripheral resistance to insulin and hepatic glucose production (1,2) . Depending on several factors, such as obesity, age of onset, mode of inheritance and severity of glucose intolerance, clinical features of individuals suffering from type 2 diabetes are highly variable.Despite being one of the most common non-communicable diseases in the world, the exact mechanism (or mechanisms) leading to glucose intolerance is still not clear (1,3) . Recently, mitochondrial dysfunction due to oxidative damage has become known as a major contributor to ageing, to degenerative diseases such as cancer, and to the metabolic syndrome, obesity and type 2 diabetes (4,5) . A group of antioxidants/ metabolites which can act to improve mitochondrial function and protect mitochondria from oxidative damage, when supplemented in the diet, have been defined as mitochondrial † These authors contributed equally to this work.