Type 2 diabetes is the result of years of an “inflamed state” within the body that results in loss of beta cells (those that produce insulin) in the pancreas and reduced insulin production. The low-grade inflammation that persists throughout the body for many years is a major reason for full-blown diabetes as well as many of the health complications associated with it.
This inflamed state is usually the result of “oxidative stress,” production of large amounts of “free radicals” which are highly reactive chemical entities that destroy normal cellular structure. Oxidative stress itself is a result of poor nutrition and unhealthy lifestyle choices. Our body has its own antioxidant capabilities but when the amount of free radicals produced during normal metabolic functions exceeds the antioxidant capabilities of the body, the body is said to be under a state of oxidative stress.
Alpha lipoic acid (ALA) is one of the many potent antioxidants produced by our bodies. It is soluble in both fats and water, thereby capable of working throughout the body. ALA is capable not only of attacking free radicals, but also helping other antioxidants regenerate. This and many other unique features have led to the discovery of the relationship between alpha lipoic acid and diabetes.
If the measures to control the blood sugar levels with type 2 diabetes are inadequate, you might be at risk of certain complications such as heart disease, diabetic retinopathy, diabetic neuropathy, etc.
For many years, ALA has been used as a supplement for treating certain types of nerve damage. Several studies suggest that it might also help relieve neuropathy – a prolonged aftereffect of type 2 diabetes. ALA is also known to perform a supporting role in:
- Improving insulin sensitivity
- Lowering blood sugar and cholesterol
- Improving blood vessel tone, and
- Decreasing inflammation and oxidative stress
(Alpha-lipoic acid should not be confused with alpha linolenic or alpha linoleic acid, which is also commonly abbreviated as ALA.)
Alpha-lipoic Acid and Type 2 Diabetes: The Research
One study that assessed the effect of oral administration of alpha-lipoic acid on insulin sensitivity with a dosage of alpha-lipoic acid (600 mg twice daily), for a period of 4 weeks found that insulin sensitivity in the patients increased significantly.
Another study was conducted to evaluate the role of alpha-lipoic acid in the treatment of diabetic neuropathy. The study included 20 diabetes type 2 patients with diabetic neuropathy, divided into 2 groups depending on blood sugar control. Each of the patients was treated with oral anti-diabetics, insulin and alpha-lipoic acid preparation for 4 months. Before the treatment, all the patients felt a burning or prickling sensation in the hands, feet, legs or other parts of the body (a condition referred to as paresthesia). After the treatment, patients with good blood sugar control were found to have reduced symptoms of diabetic neuropathy.
How Alpha-lipoic Acid Works
In the human body, glucose is converted into energy inside small organelles (called “mitochondria”) within cells. These activities that finally generate energy are carried out by specific enzymes. Enzymes are “biological catalysts,” substances that dramatically increase the rate of a chemical reaction. Alpha-lipoic acid functions as a co-enzyme for these enzymes. In other words, alpha-lipoic acid must be available for the enzyme to perform an activity and bring about the specific result.
Secondly, alpha-lipoic acid is an antioxidant, with powerful antioxidant capabilities equal to that of vitamin C, vitamin E and coenzyme Q10. It is termed as a ‘universal’ antioxidant due to its unique ability to neutralize free radicals within aqueous and fat-containing regions of the cells, as well as in intracellular (inside the cell) and extracellular (outside the cell) environments.
Free radicals are constantly being produced in the body as a by-product of biochemical reactions. An antioxidant functions to remove these potentially damaging free radicals or oxidizing agents from the body. As noted earlier, if the body is unable to balance between the production of free radicals and their removal by antioxidants, it results in oxidative stress.
In type 2 diabetes, two things happen simultaneously – disproportionate production of free radicals and decline of antioxidant defense mechanisms. Hence, oxidative stress is usually high in diabetic patients, which can promote the development of complications. In the supplement form, alpha-lipoic acid supports to reduce the oxidative stress by helping the body to get rid of the excess free radicals.
Natural Sources of Alpha-lipoic Acid
Alpha-lipoic acid is found in many foods in small amounts. Alpha lipoic acid food sources are:
- Brussels sprouts
- Rice bran
- Red meat
- Organs like kidney, liver and heart
- Brewer’s yeast
How to Consume Alpha-lipoic Acid
Alpha-lipoic acid is produced in very small quantities in the body, not sufficient to counter the effects of oxidative stress. Moreover, dietary ALA has limited benefit to the body as it is bound to an amino acid (lysine) and cannot freely circulate to perform its function. Hence, ALA supplements are usually advisable, which ensures that unbound ALA is available to act as a potent antioxidant.
ALA can occur in two forms – R-lipoic acid and S-lipoic acid. R-lipoic acid is the natural form, generally found in foods, and is the most beneficial against reactive oxygen species. A study found that the R-form was better absorbed inside the body than the S-form. Another study found that R-lipoic acid is more suitable for the treatment of diabetes and insulin resistance as compared to S-lipoic acid. While choosing the supplement make sure it is of the right kind.
How Much Would Help?
ALA is available in different dosage forms for diabetic patients. It can be either taken as an oral supplement or administered intravenously. However, there is no established dosage for ALA. A study of 72 patients with type 2 diabetes found that there is no significant difference in insulin sensitivity with 3 different doses – 600 mg/day, 1200 mg/day and 1800 mg/day, indicating that 600 mg/day may be the maximum effective dose. It is recommended to consult your doctor about the required dose and method of administration.
Is Alpha-lipoic Acid Safe?
In general, ALA supplementation in low and moderate doses when administered properly, is found useful in treatment of several disorders including acute and chronic liver diseases, diabetes neuropathy and cancer. However, it is associated with some common side effects like:
High doses of injected ALA may cause damage to the “powerhouses” of the cells, the mitochondria and this in turn may accelerate liver damage. The safety of ALA supplements in pregnant and lactating women has not yet been established.
Dosage of ALA in diabetic patients should be closely monitored. As evidence supports that ALA improves insulin sensitivity and glucose uptake, it is possible that ALA supplementation along with anti-diabetic drugs may drastically lower the blood sugar levels.
If you are under medication for any other type of treatment, it is better to consult your doctor before starting ALA supplementation, in case there is a possible interaction of ALA with other drugs.
Alpha-lipoic Acid and Diabetes: The Verdict
The use of alpha-lipoic acid has often been advantageous to treat the following:
- Oxidative Stress
The above conditions are usually a manifestation of prolonged diabetes. Hence, it is possible that ALA supplements can alleviate some of the complications of type 2 diabetes. However, including ALA in the treatment regimen for diabetes should be done strictly under the supervision of a doctor. If low doses of ALA can medically help a condition, extremely high doses can have a counter effect too. Also, special care should be taken when ALA is administered intravenously, as high amounts may be lethal.
ALA supplements can improve the lives of diabetic patients, but it is no panacea, unless the treatment regimen also includes a holistic diet and exercise. Reducing stress and having a positive outlook of the future helps immensely. With the right kind and amount of discipline, diabetes can be effectively reversed.