Nalan OKUROĞLU, Meltem SERTBAŞ, Müzeyyen ERYILMAZ, Nüket MANUKYAN, Ayşegül ŞAHİNSEV, Yasar SERTBAŞ, Ali ÖZDEMİR

Diyabetik polinöropatili hastalarda alfa lipoik asidin glisemik kontrol üzerine etkisi

GİRİŞ ve AMAÇ: Amaç: Mitokondriyal dehidrojenaz enzimlerindeki kompleksler için doğal bir kofaktör olan alfa-lipoik asidin ALA , diyabetik periferik nöropati DPN semptomlarını iyileştirdiği bildirilmiştir. DPN üzerindeki anti-oksidan etkisinin yanı sıra, mevcut kanıtlar ALA'nın glisemik düzenleme üzerindeki olumlu etkisini göstermektedir. Biz bu çalışmamızda, DPN hastalarında 600 mg oral ALA'nın glisemik kontrol üzerindeki etkisini değerlendirmeyi amaçladık.YÖNTEM ve GEREÇLER: Bu çalışmaya 84 diyabetik hasta 55 kadın, 29 erkek katıldı. Hastalar Nöropati Disabilite Skoru NDS ve Nöropati Semptom Skoru NSS ile değerlendirilerek DPN varlığına göre iki gruba ayrıldı. 3 ay boyunca DPN grubuna diğer diyabet tedavilerine ek olarak 600 mg/gün ALA başlanırken diyabeti olmayan hastalarmevcut tedavileri ile devam edildi. Tedavi başlangıcı öncesi ve 3 ay sonrası kan glukozu, HbA1c, total kolesterol, trigliserid düzeyleri karşılaştırıldı, NSS ve NDS hesaplandı.BULGULAR: ALA kullanan DPN grubunda, tedavi öncesi ortalama açlık glikoz seviyeleri 116,65 mg/dl ve 2. kontrolde 116,33 mg/dl p = 0,837 ve kontrol grubunda 117,55mg/dl ve 119,5mg/dl’dı p = 0,480 . ALA kullanan grupta HbA1c düzeyleri 1. vizitte % 6.16 ve 2. vizitte % 6.26 saptandı p = 0,283 . Kontrol grubunda ise HbA1c seviyeleri başlangıçta% 6,07 ve 2. vizitte % 6,26 idi p = 0,065 .TARTIŞMA ve SONUÇ: Diyabetik nöropatide oral ALA tedavisinin, açlık plazma glukozu ve Hba1c düzeylerine olumlu etkisi bulunmamaktadır. Klinisyenlerin HbA1c hedeflerine ulaşmak için polifarmasiden kaçınarak randomize klinik çalışmalarla ispatlanmış etkin anti-hiperglisemik ajanları tercih etmesi önerilir.

Anahtar Kelimeler:

Alfa lipoik asit, Glisemik kontrol, HbA1c

The effect of Alpha lipoic acid on glycemic control in patients with diabetic polyneuropathy

INTRODUCTION: Alpha-lipoic acid ALA , a natural co-factor for complexes in mitocondrial dehydrogenase enzymes, had reported to improve symptoms of diabetic peripheral neuropathy DPN . Besides its anti-oxidant effect on DPN, existing evidence suggests the favorable efficacy of ALA on glycemic regulation. We aim to evaluate the effect of 600 mg orally ALA on glycemic control in patients with DPN. METHODS: 84 diabetic patients women: 55, men: 29 participated in this study. The patients were grouped into two according to the presence of DPN evaluated by Neuropathy Disability Score NDS and Neuropathy Symptom Score NSS . DPN diagnosed group received oral 600 mg/daily ALA addition to their diabetes medication whereas non-DPN group preceeded with their current treatment for three months. Blood glucose, HbA1c, total cholesterol, triglycerides levels were compared before and after the treatment. NSS and NDS was performed at the first and second visit.RESULTS: In ALA treated DPN group, the mean fasting glucose levels before treatment was 116,65 and 116,33 mg/dl end of the treatment p=0,837 and in the control group 117,55 mg / dl and 119,5, respectively p=0,480 . We also couldn’t demonstrate statistical significance in HbA1c levels in ALA treated group as % 6.16 before and %6.26 after treatment p=0,283 . The HbA1c levels were %6,07±0,5 at baseline and second visit %6,26±0,7 in the control p=0,065 as well.DISCUSSION AND CONCLUSION: Oral ALA treatment in diabetic neuropathy has no benefical effects on fasting plasma glucose and Hba1c levels. To achieve HbA1c goals, clinicians should focus on approved potent anti-hyperglycemic agents to avoid polypharmacy, over and underprescribing.

Keywords:

Alpha lipoic acid, Glycemic control, HbA1c,

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