FPIN's Help Desk Answers

Alpha-Lipoic Acid for Treatment of Diabetic Peripheral Neuropathy


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Am Fam Physician. 2016 May 1;93(9):786.

Clinical Question

Does alpha-lipoic acid (ALA) improve diabetic peripheral neuropathy?

Evidence-Based Answer

Intravenous (IV) ALA can improve neuropathy symptoms when administered for three weeks, but symptom improvement with oral ALA is not clinically significant. (Strength of Recommendation: B, based on two meta-analyses of randomized controlled trials [RCTs].) There is no evidence evaluating long-term treatment.

Hyperglycemia can increase production of free oxygen radicals. Increased levels of free radicals have been associated with diabetic complications. Antioxidants such as ALA could theoretically be effective in treating diabetic peripheral neuropathy. A meta-analysis of four RCTs (N = 653) evaluated the effectiveness of ALA vs. placebo

Address correspondence to Scott Bartkoski, MD, at sjb242@gmail.com. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.


1. Mijnhout GS, Kollen BJ, Alkhalaf A, Kleefstra N, Bilo HJ. Alpha lipoic acid for symptomatic peripheral neuropathy in patients with diabetes: a meta-analysis of randomized controlled trials. Int J Endocrinol. 2012;2012:456279.

2. Han T, Bai J, Liu W, Hu Y. A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol. 2012;167(4):465–471.

Help Desk Answers provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review.

The complete database of evidence-based questions and answers is copyrighted by FPIN. If interested in submitting questions or writing answers for this series, go to http://www.fpin.org or e-mail: questions@fpin.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.


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