Doughnut hole solution to the healthcare crisis, Cigna would

approve.

in his feet... he goes to a doctor, perhaps a specialist. He has never heard of alpha lipoic acid. He will continue to deteriorate in spite of the following articles.

1: JAMA. 2009 Oct 7;302(13):1451-8. Epub 2009 Sep 8.Click here to read Links
A 52-year-old woman with disabling peripheral neuropathy: review of diabetic polyneuropathy.
Rutkove SB.

Harvard Medical School, and Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, TCC-810, Boston, MA 02215, USA. srutkove@bidmc.harvard.edu

Ms Q is a 52-year-old woman who has had progressive polyneuropathy in the setting of diabetes for the past 8 years. Ms Q's major disability is that of increasingly severe neuropathic pain and cramps that have been poorly responsive to a variety of therapies, including gabapentin and topiramate. The diagnosis of and differential diagnosis for diabetic polyneuropathy are reviewed herein. In general, treatment options for diabetic polyneuropathy remain primarily symptomatic. Improving the metabolic profile through weight loss, exercise, and if necessary, medications may help slow neuropathy progression. Many medications are effective in reducing pain, and newly developed ones, such as pregabalin and duloxetine, while specifically marketed for diabetic neuropathy, are likely to be no better and are considerably more expensive than older ones. Alpha-lipoic acid appears to be effective as well.

1: Diabet Med. 2007 Sep;24(9):1034-8. Epub 2007 May 8.Click here to read Links
The effect of alpha-lipoic acid on symptoms and skin blood flow in diabetic neuropathy.
Jin HY, Joung SJ, Park JH, Baek HS, Park TS.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University, Medical School, Jeon-ju, South Korea.

AIMS: Multiple pathogenic pathways are involved in diabetic neuropathy and diverse treatments have been tried without success. The aim of this study was to assess the effect of alpha-lipoic acid on skin blood flow in patients with diabetic neuropathy. METHODS: We measured skin blood flow in 13 control subjects and 19 patients with diabetic neuropathy using the laser Doppler blood flow technique. Skin blood flow and the extent of skin blood flow changes were compared before and after diabetic patients received 600 mg/day alpha-lipoic acid intravenously for 14 days. RESULTS: Although no significant differences in absolute values of skin blood flow or in the extent of changes were noted, symptoms were reduced after alpha-lipoic acid treatment. CONCLUSIONS: This study suggests that alpha-lipoic acid, a potent antioxidant, improves symptoms of diabetic neuropathy. Larger studies are needed to determine whether improvements in skin blood flow also occur in patients with diabetic neuropathy.

1: Nutr Rev. 2008 Nov;66(11):646-57.Click here to read Click here to read Links
Alpha-lipoic acid supplementation and diabetes.
Singh U, Jialal I.

Laboratory of Atherosclerosis and Metabolic Research, Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, California 95817, USA.

Diabetes is a common metabolic disorder that is usually accompanied by increased production of reactive oxygen species or by impaired antioxidant defenses. Importantly, oxidative stress is particularly relevant to the risk of cardiovascular disease. Alpha-lipoic acid (LA), a naturally occurring dithiol compound, has long been known as an essential cofactor for mitochondrial bioenergetic enzymes. LA is a very important micronutrient with diverse pharmacologic and antioxidant properties. Pharmacologically, LA improves glycemic control and polyneuropathies associated with diabetes mellitus; it also effectively mitigates toxicities associated with heavy metal poisoning. As an antioxidant, LA directly terminates free radicals, chelates transition metal ions, increases cytosolic glutathione and vitamin C levels, and prevents toxicities associated with their loss. These diverse actions suggest that LA acts by multiple mechanisms both physiologically and pharmacologically. Its biosynthesis decreases as people age and is reduced in people with compromised health, thus suggesting a possible therapeutic role for LA in such cases. Reviewed here is the known efficacy of LA with particular reference to types 1 and 2 diabetes. Particular attention is paid to the potential benefits of LA with respect to glycemic control, improved insulin sensitivity, oxidative stress, and neuropathy in diabetic patients. It appears that the major benefit of LA supplementation is in patients with diabetic neuropathy.