Effect of Alpha-Lipoic Acid in the Treatment of Diabetic Neuropathy: A Systematic Review

Diabetic neuropathy is a clinical condition that can have a significant impact on quality of life, presenting as numbness, tingling, and burning in the extremities. Current treatment options focus on symptom alleviation and reducing exposure to risk factors as treating the pathophysiological causes of diabetic neuropathy remains a significant challenge. Novel studies have proposed that the use of antioxidants, including alpha-lipoic acid (⍺-lipoic acid), may represent a beneficial intervention for treating neuropathic pain in diabetic patients. This study aims to evaluate the effect of ⍺-lipoic acid in the treatment of diabetic neuropathy and determine its effectiveness in reducing the symptoms of diabetic neuropathy. To achieve our objective, PubMed, Scopus, and Web of Science databases were screened on March 3, 2022. Randomized controlled trials that investigated ⍺-lipoic acid treatment in diabetes mellitus patients with neuropathic pain and made an appropriate comparison were included. The reduction of neuropathic symptoms was the primary outcome, and the secondary outcome was the incidence of adverse events. Eight studies comprising 1,500 diabetic patients were evaluated in this systematic review. The findings were inconsistent among the literature concerning the effectiveness of ⍺-lipoic acid in the treatment of diabetic neuropathy, with three trials (37.5%) observing significant improvements in symptoms and five trials (62.5%) not observing any notable results. All studies found ⍺-lipoic acid to be a safe and tolerable intervention, with no reported adverse effects. The administration of ⍺-lipoic acid may result in symptom reduction and offers a safe and tolerable treatment option. However, there is limited evidence to support the beneficial outcomes of this approach. Further trials are warranted to corroborate or contradict the hypothesis that ⍺-lipoic acid is an effective intervention for the treatment of diabetic neuropathy.