Background: This study aims to assess oral alpha lipoic acid’s (ALA’s) safety and effectiveness in managing diabetic neuropathy. Methods: A thorough search of the literature was conducted using PubMed, Google Scholar, and Embase databases, and the study was performed as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Based on inclusion and exclusion criteria, nine randomized controlled trials (RCTs) comprising 1,345 subjects were selected. The results showed that ALA has shown significant reduction in glycated hemoglobin (HbA1C) inverse variance (IV): –0.66, (–0.81 → –0.51) at 95% CI, p < 0.00001, I2 = 92%, neuropathy impairment score (NIS) IV: –1.19, (–2.28 → –0.09) at 95% CI, p = 0.03, I2 = 58%, along with improving the neuropathy symptoms and change (NSC) number IV: –0.18, (–0.35 → –0.01) at 95% CI, p = 0.04, I2 = 0%, NSC severity score IV: –0.65, (–0.83 → –0.48) at 95% CI, p < 0.00001, I2 = 89%, total severity score (TSS) IV: –0.43, (–0.59 → –0.27) at 95% CI, p < 0.00001, I2 = 98%, neurological disability score (NDS) IV: –0.72, (–1.03 → –0.40) at 95% CI, p < 0.00001, I2 = 98%, vibration perception threshold (VPT) IV: –0.35, (–0.50 → –0.19) at 95% CI, p < 0.0001, I2 = 96% and global satisfaction Mantel-Haenszel (M-H) odds ratio (OR): 3.51, (1.06 → 11.61) at 95% CI, p = 0.04, I2 = 72% when compared to the control or placebo group. However, ALA has not shown significant changes in motor nerve conduction velocity (MNCV) score IV: 0.26, (–0.44 → 0.96) at 95% CI, p = 0.47, I2 = 49% and NIS-low limb (NIS-LL) IV: –0.58, (–1.35 → 0.19) at 95% CI, p = 0.14, I2 = 0% when compared to the placebo group. Discussion: Based on the available moderate to high-quality evidence, we can conclude that oral administration of ALA at doses of 600–1,800 mg may be beneficial in improving/alleviating the symptoms resulting from diabetic neuropathy.
Das et al. (Fri,) studied this question.