There are different grades of neuropathy in the diabetic person. Diabetic neuropathy might be a focal syndrome, a distal sensorimotor and/or autonomic syndrome or it might be subclinical and simply show up as an abnormality on neurologic testing. Diabetic neuropathy is a major public health problem and should be treated as soon as possible.
About 25% of diabetics will have some type of neuropathy. Distal sensorimotor neuropathy causes a lot of health problems and is the source of foot ulcers, amputations.
Osteoarthropathy, poor healing, dry and cracked skin, abnormal nails, ligament instability, tight Achilles tendons and pain. Amputation rates are 15-times more in the diabetics than in the rest of the population.
Almost 20% of diabetics will have neuropathic pain. This dramatically ruins quality of life, sleep and functional abilities.
It is very difficult to treat this painful condition well. Most physicians try to achieve better glucose control, reduce risk factors for foot damage and treat the pain with pain medications.
Most of the available medications are inadequate and have significant side effects. The normal group of medications used for neuropathic pain include antidepressants, opioids and anticonvulsants.
Today, physicians are also sometimes able to recommend THC as a remedy.
HOW ALA HELPS DIABETIC NEUROPATHY
Diabetic neuropathy is the end-result of chronic low-grade inflammation and oxidative stress. The hyperglycemia and poor blood flow found in diabetics start the problems. There is an accumulation of advanced glycation end products (AGE); these bind to receptors on the neurons themselves and cause oxidative stress.
There is poor circulation at the microscopic level that feeds the nerves themselves, this results in hypoxia and nitric oxide inactivation. The AGEs also induce NF-kB (nuclear factor-kappa beta) which further causes oxidative stress.
The hyperglycemia and hypoxia also damage the mitochondria of the nerve cells over time. The oxidation causes lipid peroxidation and cellular destruction.
The increased levels of glucose in the serum of diabetics leads to auto-oxidation and the production of AGEs. This is considered a major cause of the ROS found in the peripheral nerves and other organ tissues.
This glycation damages natural antioxidants and therefore, not only are more ROS produced but fewer can be cleared. Exogenous (external) sources of antioxidants are mandatory.
Alpha lipoic acid normalizes endoneurial activity of an important functional enzyme (Na-K-ATPase). It also improves the uptake of myo-inositol in the nerve cells. This is generally depleted in the hyperglycemic state. Additionally, alpha lipoic acid increases the glucose uptake and the ability of the cell to produce energy.
Sources:
Ziegler et al. Oral treatment with ALA improves symptomatic diabetic polyneuropathy. the SYDNET 2 trial. Diabetes Care 2006. 29:2365-2370
Ziegler et al. ALA in the treatment of diabetic peripheral and cardiac autonomic neuropathy. Diabetes. 1997. 46(supp 2) S62-66
Redjanovic et al. The ALADIN II study group: Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (ALA) a two-year multicenter randomized double-blind placebo controlled trial. Free Radic res 1999. 31:171-179
Ziegler et al. ALADIN I study Group. Treatment of symptomatic diabetic neuropathy with the anti-oxidant ALA: a 3-week multicenter randomized controlled trial (ALADIN Study). Diabetologia 1995. 38:1425-1433
Sola M et al. Imbesartan and ALA improve endothelial function and reduce markers of inflammation in the metabolic syndrome: results of the Imbesartan and Lipoic acid in endothelial dysfunction (ISLAND) study. Circulation 2005. 111:343-348
HAVE YOU CHECKED OUT WELL THEORY'S ALPHA-LIPOIC ACID SUPPLEMENT?
Dr. Meredith Warner loves Alpha-lipoic Acid for those with Peripheral Neuropathy to help with the pain, numbness, and tingling!
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