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NMU 121 – ALA in Diabetic Neuropathy

Nutrition / Natural Medicine Update No 121 (March 6, 2019)

with Dr. James Meschino


Topic: ALA Supplement Improves Diabetic Neuropathy: 1/3 of Diabetics Develop Neuropathy

Source: Journal, Diabetic Care (March 2019)


About one-third of diabetics develop a serious type of nerve damage (symmetrical sensorimotor polyneuropathy or DSPN) or neuropathy that impacts their quality of life, increases their risk of having a foot or leg amputation and increases the risk of mortality. Diabetic neuropathy symptoms can include constant pins and needles sensation, usually in the feet, or loss of sensation, imbalance, muscle weakness, bone fractures and joint collapse within the foot (Charcot’s foot), which can lead to an impaired ability to walk as well as foot pain. Long-term studies in type 2 diabetic patients indicate that currently available diabetic drugs, nutrition, and lifestyle therapies, as well as improving cardiovascular risk factors (high cholesterol, high blood pressure) in these patients are not sufficiently effective in slowing the progression of diabetic neuropathy problems. As such, researchers have been looking for novel agents that can slow, stabilize and/or reverse aspects of this problematic and dangerous neuropathy that commonly afflicts diabetics.

This brings us to the research paper published in the March 2019 issue of the journal Diabetic Care, which showed that diabetics with neuropathy problems greatly benefit from taking a supplement each day known as alpha-lipoic acid (ALA). Previous studies have shown promising results with ALA in the treatment of diabetic neuropathy, but no long-term studies had been undertaken. In this study, researchers wanted to evaluate the efficacy and safety of ALA in diabetic neuropathy patients over a 4-year period. This multicenter, randomized double-blind, placebo-controlled study involved 460 diabetic patients with mild-to-moderate neuropathy problems. Half the patients ingested 600 mg per day of an ALA supplement and the other half ingested a placebo pill. The results showed that the ALA group exhibited a reversal of muscular weakness and other aspects of neuropathy, whereas the placebo group continued to show the further progression of muscle weakness and other neuropathy disease signs and symptoms.


How does ALA work? ALA is a powerful antioxidant and evidence shows that at a high enough dose (600 mg/d) it improves blood flow to nerve fibers, enabling them to access more oxygen and nutrients from the bloodstream. This helps to prevent progression of the neuropathy and it also enables damaged nerve fibers to repair themselves to a certain degree. The antioxidant effect has also been shown to reduce inflammation within the bloodstream and nerve fibers, and ALA has also been shown to improve blood sugar (glucose) regulation to a certain degree in diabetic patients. The combination of all these effects is likely responsible for the positive outcomes diabetic patients have had in managing neuropathy problems when ALA is included in the treatment plan.

The researchers conclude, “four-year treatment with ALA in mild-to-moderate symmetrical neuropathy (DSPN) resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated” – meaning no dangerous or serious side effects occurred. There were also fewer deaths in the ALA-treated patients than in the placebo group.

ALA is an over-the-counter supplement that is found in many drug and health food stores. I think that diabetic patients should be aware of it and should speak to their doctor about this research, as it impacts the prevention and treatment of diabetic neuropathy.

The reference for this paper can be found in the text below.


Ziegler D et al. Efficacy and safety of antioxidant treatment with alpha-lipoic acid over 4-years in diabetic polyneuropathy. Journal, Diabetic Care. 2019, 42 (3): 2054-2060.


Eat Smart, Live Well, Look Great,

Dr. Meschino

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