Diabetes is the metabolic condition that occurs when the blood glucose or blood sugar in the body is high. The normal reading for blood sugar level in the body for fasting should be between 4 mmol/l to 6 mmol/l, whereas after food should be less than 8 mmol/l. As for using more precise indicator of blood sugar level is by measuring HbA1c, it should be not more than 6.5 mmol/l. HbA1c is a much more precise indicator since it measures the amount of glucose bound to the red blood cells in the last three months. The higher the blood sugar levels the higher the HbA1c values (1,2, 3).
Blood glucose is the main source of energy and it comes from the food that we consumed. In order to convert this energy from food, that we consumed to the cells, body need, a hormone called insulin, which is made in pancreas, with the help from this insulin hormone, energy from food is then converted into the cells. Complication occur when, body does not able to make enough or any insulin or does not use insulin well, thus glucose or sugar stays in the blood and does not reach the cells (2).
Over time, having too much glucose in blood can cause health problems. Although diabetes has no cure, individuals can take steps to manage your diabetes and stay healthy. Some of the complication with relation to diabetes are, cardiovascular disease, diabetes neuropathy (nerve damage), nephropathy (kidney damage), retinopathy (eye damage) and many more.
In this article, we are going to focus on the complication with regards to the nerve damage or so called, neuropathy. Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish nerves, especially in legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. If it is left untreated, individual could lose all sense of feeling in the affected limbs (4).
There are many researches that are conducted in effort to lower the risk of diabetic neuropathy complication, among that is the usage of Alpha Lipoic Acid (ALA). ALA is the type of antioxidant that is found in many types of food, but very low in quantity. It is found in food such as spinach, broccoli, yams, tomatoes, potatoes, carrot, beets, and rice bran. Whereas in animal-based food, higher concentration of lipoic acid (LA) is found in the heart, liver, and kidney (5).
Human body can synthesize LA in the liver. LA or ALA is function as to helps in glucose and lipid metabolism, as an anti-inflammation, has an antioxidant property which can be used to regenerate the other antioxidant and reparation of oxidized protein and chelating of metal ions. Whereas in the body of the individuals with diabetes, ALA increase the sensitivity of the insulin (6).
As an antioxidant, ALA or LA, helps in fighting free radicals or oxidative stress that comes from three sources in the body of the individuals of diabetes mellitus, which is from mitochondrial pathway, enzymatic pathway or non – enzymatic pathway. As for the function of ALA that is focused on diabetes itself, several clinical trials have found now found that ALA may increase insulin sensitivity and help to reduce blood sugar and lipid. There are two detailed study involving this, which is when ALA is being administered for two weeks in 22 patients and improvement is seen on the fasting and average glucose level, insulin sensitivity, LDL and HDL, and total cholesterol, however the study is too short to measure the HBa1C level. So, another study with regards to this is the study that administered ALA orally to 74 patients for 4 weeks, this study also found the improvements on the insulin resistance and fasting glucose (7).
As for the function of ALA solely on the diabetic neuropathy, it is a possible alternative remedy for diabetic neuropathy. Neuropathy or nerve damage is a permanent and common complication with diabetes. However, the symptoms can be alleviated by using ALA (8).
There are two types of neuropathy which is peripheral neuropathy which most commonly occur in feet and legs but can also sometimes occur in hands and arms. It can also cause numbness or inability to feel changes in temperature, tingling or burning sensation, muscle weakness, a loss of balance, foot problems including ulcer or infection, sharp pain, or cramps. Whereas autonomic neuropathy can affect your autonomic nervous system such as heart, bladder, lungs, stomach, and intestines, this include difficulty of swallowing, constipation or uncontrollable diarrhea, bladder problems, erectile dysfunction, decrease or increase in sweating, sharp drops in blood pressure and many more (8).
In conclusion, studies show that ALA is able to helps in alleviating symptoms of diabetes and diabetes neuropathy. However, the right management of diabetes such as the intake of its medication such as metformin and diet control together with the physical activity must be done side to side.
- National Institute if Diabetes, Digestive and Kidney Disease (NIDDK). United States Department of Health and Human Services. What is Diabetes? https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes#:~:text=Diabetes%20is%20a%20disease%20that,to%20be%20used%20for%20energy. (Accessed on June 16, 2020).
- National Diabetes Institute of Malaysia (NADI). https://www.diabetesmalaysia.com.my/article.php?aid=8#:~:text=Your%20target%20blood%20glucose%20levels,in%20the%20last%203%20months. (Accessed on June 16, 2020).
- Clinical Practice Guideline (CPG) for Management of Diabetes Mellitus Type 2. 5th Ministry of Health Malaysia (MOH). https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Endocrine/3b.pdf (Accessed on June 16, 2020).
- Mayo Clinic. Diabetes. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444 (Accessed on June 16, 2020).
- Alpha Lipoic Acid Supplement. https://www.webmd.com/diabetes/supplement-guide-alpha-lipoic-acid (Accesed on June 16, 2020).
- Saeid Golbidi, Mohammad Badran and Ismail Laher. Diabetes and Alpha Lipoic Acid (2011). Frontiers in Pharmacology. Journal of Pharmacology.NCBI. DOI 10.3389/fphar.2011.00069
- Diabetes Action. Alpha Lipoic Acid. https://diabetesaction.org/article-alpha-lipoic-acid#:~:text=While%20most%20of%20the%20research,of%20oxidative%20stress%20and%20inflammation. (Accessed on June 16, 2020).
- Alpha Lipoic Acid (ALA) and Diabetic Neuropathy. https://www.healthline.com/health/alpha-lipoic-acid-and-diabetes (Accessed on June 16, 2020).