Overview
This systematic review and meta-analysis evaluated the efficacy of alpha-lipoic acid (ALA) supplementation in patients with diabetic neuropathy by analyzing relevant randomized controlled trials. Results indicate that ALA has a generally favorable effect on neurological symptoms, although some studies found no significant benefit compared to placebo.
Background and Objectives
- Diabetic neuropathy is a prevalent complication of diabetes, affecting up to 50% of patients.
- Current treatments focus on symptom control rather than cure.
- Study aimed to assess the efficacy and safety of ALA compared to other interventions for diabetic neuropathy.
Methods
- Literature search included PubMed, Scopus, Web of Science, and Cochrane Library (2019–2023).
- Inclusion: RCTs of diabetic patients with neuropathy studying ALA’s effects versus placebo or other treatments.
- Exclusion: Non-English, incomplete, animal, unpublished, and conference studies.
- Data extraction covered study details, interventions, outcomes, and results.
- Quality assessment was performed using the Cochrane risk of bias tool.
- Analysis was conducted using RevMan (version 5.4), including mean differences and relative risks.
Study Selection and Characteristics
- 119 articles identified; 4 RCTs (358 patients) were included in final analysis.
- Sample sizes ranged from 24 to 200; follow-up periods from 5 weeks to 6 months.
- Both oral doses of 600 mg/day and 1,663 mg/day ALA were examined.
Results
- ALA significantly improved total symptoms score (TSS) versus control (MD, -6.63; 95% CI: [-9.78, -3.48]).
- Dose-dependent improvements were observed for symptom relief and patient satisfaction.
- Three RCTs showed significantly better neurological disability scores (NDS) with ALA.
- Two RCTs reported no significant benefit over placebo for pain intensity.
- No major safety concerns or increase in adverse events were reported.
Discussion
- ALA appears effective in reducing diabetic neuropathy symptoms, especially at higher or prolonged doses.
- Some heterogeneity among studies limits the generalizability of findings.
- Optimal dosage and administration route remain unclear.
- More research is needed to confirm findings and optimize ALA therapy.
Strengths and Limitations
- Strengths: Inclusion of RCTs and adherence to PRISMA guidelines.
- Limitations: High heterogeneity, small sample sizes in some studies, and limited long-term outcome data.
Conclusion
- ALA supplementation is generally safe and shows a satisfactory effect on neurological symptoms in diabetic neuropathy.
- Further studies are recommended to establish long-term efficacy and optimal dosing.
Recommendations / Advice
- Consider ALA as a possible adjunct for managing diabetic neuropathy symptoms.
- Larger, longer-term RCTs are needed to establish definitive recommendations for clinical use.