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Oral administration of rac-α-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial
Abstract
Alpha-lipoic acid (ALA), a naturally occuring compound and a radical scavenger was shown to enhance glucose transport and utilization in different experimental and animal models. Clinical studies described an increase of insulin sensitivity after acute and short-term (10 d) parenteral administration of ALA. The effects of a 4-week oral treatment with alpha-lipoic acid were evaluated in a placebo-controlled, multicenter pilot study to determine see whether oral treatment also improves insulin sensitivity. Seventy-four patients with type-2 diabetes were randomized to either placebo (n = 19); or active treatment in various doses of 600 mg once daily (n = 19), twice daily (1200 mg; n = 18), or thrice daily (1800 mg; n = 18) alpha-lipoic acid. An isoglycemic glucose-clamp was done on days 0 (pre) and 29 (post). In this explorative study, analysis was done according to the number of subjects showing an improvement of insulin sensitivity after treatment. Furthermore, the effects of active vs. placebo treatment on insulin sensitivity was compared. All four groups were comparable and had a similar degree of hyperglycemia and insulin sensitivity at baseline. When compared to placebo, significantly more subjects had an increase in insulin-stimulated glucose disposal (MCR) after ALA treatment in each group. As there was no dose effect seen in the three different alpha-lipoic acid groups, all subjects receiving ALA were combined in the "active" group and then compared to placebo. This revealed significantly different changes in MCR after treatment (+27% vs. placebo; p < .01). This placebo-controlled explorative study confirms previous observations of an increase of insulin sensitivity in type-2 diabetes after acute and chronic intravenous administration of ALA. The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes. The encouraging findings of this pilot trial need to be substantiated by further investigations.
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“Indeed, alloxan diabetic rats are observed to have reduced NO levels in blood (656) , and in human subjects, acute hyperglycaemia attenuated endothelium-dependent vasodilation (657) .”
From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [656]
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Metadata
- Authors
- Jacob, S., Ruus, P., Hermann, R., Tritschler, H. J., Maerker, E., Renn, W., Augustin, H. J., Dietze, G. J., & Rett, K.
- Affiliations
- Max Grundig Klinik (DE)
- University of Tübingen (DE)
- Corresponding author
- Jacob, S
- ORCID
- Rett, K
- Venue
- Free Radical Biology and Medicine
- Publisher
- Elsevier BV
- Published
- 1999-08
- Volume
- 27
- Issue
- 3-4
- Pages
- 309-314
- ISSN
- 0891-5849 (ISSN-L)
- OpenAlex
- W2088208009
- Cited by
- 280
- References
- 36
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 10 · 2019: 9 · 2018: 7 · 2017: 5 · 2016: 4 · 2015: 7 · 2014: 15 · 2013: 23 · 2012: 14
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Free Radical Biology and Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Biochemical Acid Research Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- alpha-lipoic acid, type 2 diabetes, insulin sensitivity, oral administration, glucose disposal, dose comparison
- MeSH terms
- Administration, Oral, Anthropometry, Diabetes Mellitus, Type 2, Female, Humans, Insulin Resistance, Thioctic Acid, Male, Middle Aged, Pilot Projects, Stereoisomerism, Glucose Clamp Technique, Free Radical Scavengers
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