ISSN: 2451-0629
Archives of Medical Science - Atherosclerotic Diseases
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Official journal of the International Lipid Expert Panel (ILEP)
vol. 4
Letter to the Editor

Effect of 3-month α-lipoic acid treatment on sural nerve conduction velocity and amplitude in patients with diabetic neuropathy: a pilot study

Athanasia Papazafeiropoulou
Eleni Xourgia
Styliani Papantoniou
Aikaterini Trikkalinou
Andreas Melidonis 

1st Department of Internal Medicine and Diabetes Center, General Hospital of Piraeus “Tzaneio”, Piraeus, Greece
Arch Med Sci Atheroscler Dis 2019; 4: e141–e143
Online publish date: 2019/07/18
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Here we present our original research on the effects of -lipoic acid, an emerging treatment option for the management of diabetic neuropathy, on nerve conduction parameters, an indirect marker of nerve functional integrity.
Diabetic neuropathy (DN) is a common complication of type 2 diabetes (T2D) with a major impact on the patient’s quality of life. Despite therapeutic advances, there are no agents targeting the main pathogenetic mechanisms of DN [1]. One of these is oxidative stress [2]. A-lipoic acid (ALA) seems to delay or reverse peripheral diabetic neuropathy through its multiple antioxidant properties [3]. Therefore, the aim of our study was to explore the effect of ALA treatment on the sural nerve conduction velocity (SNCV) and amplitude (SNAP) of T2D patients with DN.
Our sample consisted of 32 consecutive T2D patients (12 male), with mean age (± standard deviation) 67.9 ± 8.6 years, glycated hemoglobin (HbA1c) 7.1 ±1.0%, body mass index 30.7 ±11.2 kg/m² and T2D duration 14.1 ±5.3 years, attending the diabetes outpatient clinic of our hospital between September 2018 and February 2019. 72.7% of study patients were on oral antidiabetic medication and 26.5% on insulin therapy. Diagnosis of DN was based on the presence of at least one neuropathic symptom (burning, shooting pain, paraesthesia, muscle cramps or allodynia) in the lower extremities, and previous treatment for DN for ≥ 3 months before enrollment in the study [1]. Patients with causes of neuropathy other than diabetes (such as chronic alcohol misuse, vitamin B12 deficiency, drug-induced neuropathy), truncal neuropathy or severe neurological diseases (such as Parkinson’s disease and multiple sclerosis) and severe renal disease defined as estimated glomerular filtration rate (eGFR)  <  30 ml/min/1.73 m2 were excluded from the study. Regarding the other micro- and macrovascular diabetic complications, 14.3% of study patients had retinopathy, 28.6% chronic kidney disease, 18.2% coronary artery disease, and 47.6% peripheral arterial disease.
Participants were prescribed 600 mg/day ALA (Combinerv), to be administered orally, for 3 months, and were advised not to discontinue any other medication for DN, antidiabetic drugs, or substances used for managing arterial hypertension or dyslipidemia during the study. All study patients underwent a complete clinical examination and measurement of SNCV and SNAP using the NCstat DPNCheck test (NeuroMetrix, Inc.,...

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