Abstrait

Alpha lipoic acid a boon for diabetic peripheral neuropathy: A systematic review and meta-analysis.

Pingali Usha Rani, Mekala Padmaja, Kammila Sireesha, Penugonda Sravanasandhya

Background: Diabetic Peripheral Neuropathy (DPN) is the most prevalent chronic microvascular complication in both type 1 and type 2 Diabetes Mellitus (DM) patients. In type 2 DM, insulin resistance affects vascular endothelium resulting in endothelial dysfunction, platelet hyperactivity and oxidative stress. Alpha Lipoic Acid (ALA) a potent antioxidant, targets oxidative stress in DPN which improves nerve blood flow, distal nerve conduction, and neuropathic symptoms. Herein, we planned to review the efficacy of ALA in improving symptoms of DPN without affecting glycaemic control. Objective: To evaluate efficacy and safety ofA LA on neuropathic symptoms in DPN. Methods: A systemic search was conducted to collect and analyse all studies published from 1995 to 2020 that investigated effect of ALA on neuropathic symptoms in diabetic neuropathy patients using the phrase “Alpha lipoic acid and diabetic neuropathy". Studies were extracted from PubMed and CTRI. The Randomized Controlled Trials (RCT) which investigated effects of ALA in DPN patients were included whereas nonrandomized trials and clinical observations were excluded. The RevMan Manager 5.4 software was used for meta-analysis. The results were expressed as Weighted Mean Difference (WMD) with 95% confidence intervals (95% CIs) using a Fixed Effect (FE) or Randomized Effect (RE) model. Results: Eight RCTs met inclusion criteria. Treatment group received ALA of 300-1800 mg per day and control group received a placebo. Compared with placebo, ALA showed significant improvement in symptoms of DPN. There were no serious adverse events during treatment period. Conclusion: Our systemic review indicates a favourable effect of ALA on neuropathic symptoms in DPN patients.