Diabetes & Metabolism Journal

Original Articles

Drug/Regimen
γ-Linolenic Acid versus α-Lipoic Acid for Treating Painful Diabetic Neuropathy in Adults: A 12-Week, Double-Placebo, Randomized, Noninferiority Trial: Jong Chul Won, Hyuk-Sang Kwon, Seong-Su Moon, Sung Wan Chun, Chong Hwa Kim, Ie Byung Park, In Joo Kim, Jihyun Lee, Bong Yun Cha, Tae Sun Park; Diabetes Metab J. 2020;44(4):542-554. Published online November 4, 2019; DOI: https://doi.org/10.4093/dmj.2019.0099

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Background

This study was a multicenter, parallel-group, double-blind, double-dummy, randomized, noninferiority trial to evaluate the efficacy and safety of γ-linolenic acid (GLA) relative to α-lipoic acid (ALA) over a 12-week treatment period in type 2 diabetes mellitus (T2DM) patients with painful diabetic peripheral neuropathy (DPN).

Methods

This study included 100 T2DM patients between 20 and 75 years of age who had painful DPN and received either GLA (320 mg/day) and placebo or ALA (600 mg/day) and placebo for 12 weeks. The primary outcome measures were mean changes in pain intensities as measured by the visual analogue scale (VAS) and the total symptom scores (TSS).

Results

Of the 100 subjects who initially participated in the study, 73 completed the 12-week treatment period. Per-protocol analyses revealed significant decreases in the mean VAS and TSS scores compared to baseline in both groups, but there were no significant differences between the groups. The treatment difference for the VAS (95% confidence interval [CI]) between the two groups was −0.65 (−1.526 to 0.213) and the upper bound of the 95% CI did not exceed the predefined noninferiority margin (δ₁=0.51). For the TSS, the treatment difference was −0.05 (−1.211 to 1.101) but the upper bound of the 95% CI crossed the noninferiority margin (δ₂=0.054). There were no serious adverse events associated with the treatments.

Conclusion

GLA treatment in patients with painful DPN was noninferior to ALA in terms of reducing pain intensity measured by the VAS over 12 weeks.

Citations

Citations to this article as recorded by

Cell metabolism pathways involved in the pathophysiological changes of diabetic peripheral neuropathy
Yaowei Lv, Xiangyun Yao, Xiao Li, Yuanming Ouyang, Cunyi Fan, Yun Qian
Neural Regeneration Research.2024; 19(3): 598. CrossRef
Diyabet Tedavisinde Antioksidan Etki: Alfa Lipoik Asit
Umut DALMIŞ, Emine Merve EKİCİ
Avrasya Sağlık Bilimleri Dergisi.2024; 7(1): 68. CrossRef
Ranking Alpha Lipoic Acid and Gamma Linolenic Acid in Terms of Efficacy and Safety in the Management of Adults With Diabetic Peripheral Neuropathy: A Systematic Review and Network Meta-analysis
Mario B. Prado, Karen Joy B. Adiao
Canadian Journal of Diabetes.2024;[Epub] CrossRef
Comprehensive comparison of a new technology with traditional methods for extracting Ougan (Citrus reticulata cv. Suavissima) seed oils: Physicochemical properties, fatty acids, functional components, and antioxidant activities
Huaxia Yang, Yudan Lin, Xiaoxu Zhu, Haishuo Mu, Yi Li, Shuangyang Chen, Jia Li, Xuedan Cao
LWT.2024; 197: 115857. CrossRef
Genetic and Transcriptomic Background of Oxidative Stress and Antioxidative Therapies in Late Complications of Type 2 Diabetes Mellitus: A Systematic Review
Gašper Tonin, Vita Dolžan, Jasna Klen
Antioxidants.2024; 13(3): 277. CrossRef
Antinociceptive effects of gamma-linolenic acid in the formalin test in the rats
Kaveh Rahimi, Arman Nourishirazi, Hamidreza Delaviz, Zohreh Ghotbeddin
Annals of Medicine & Surgery.2024; 86(5): 2677. CrossRef
Alpha-lipoic acid activates AMPK to protect against oxidative stress and apoptosis in rats with diabetic peripheral neuropathy
Tianya Zhang, Dong Zhang, Zhihong Zhang, Jiaxin Tian, Jingwen An, Wang Zhang, Ying Ben
Hormones.2023; 22(1): 95. CrossRef
Pathogenetic treatments for diabetic peripheral neuropathy
Dan Ziegler
Diabetes Research and Clinical Practice.2023; 206: 110764. CrossRef
Omega-3 Nutrition Therapy for the Treatment of Diabetic Sensorimotor Polyneuropathy
Deepak Menon, Evan J. H. Lewis, Bruce A. Perkins, Vera Bril
Current Diabetes Reviews.2022;[Epub] CrossRef
Effect of Alpha-Lipoic Acid in the Treatment of Diabetic Neuropathy: A Systematic Review
Saleh A Abubaker, Abdulaziz M Alonazy, Albasseet Abdulrahman
Cureus.2022;[Epub] CrossRef
Insight into the possible mechanism(s) involved in the antinociceptive and antineuropathic activity of Descurainia sophia L. Webb ex Prantl essential oil
Donya Ziafatdoost Abed, Sajjad Jabbari, Zainul Amiruddin Zakaria, Saeed Mohammadi
Journal of Ethnopharmacology.2022; 298: 115638. CrossRef
A novel approach to alpha-lipoic acid therapy in the treatment of diabetic peripheral neuropathy
Alicja Sementina, Mateusz Cierzniakowski, Julia Rogalska, Izabela Piechowiak, Marek Spichalski, Aleksandra Araszkiewicz
Journal of Medical Science.2022; : e714. CrossRef
Pathogenesis and Treatment of Diabetic Peripheral Neuropathy
Seon Mee Kang
The Journal of Korean Diabetes.2022; 23(4): 222. CrossRef
Diabetic Neuropathy: a Critical, Narrative Review of Published Data from 2019
Ameet S. Nagpal, Jennifer Leet, Kaitlyn Egan, Rudy Garza
Current Pain and Headache Reports.2021;[Epub] CrossRef
Therapeutic Potential of Ursolic Acid in Cancer and Diabetic Neuropathy Diseases
Manzar Alam, Sabeeha Ali, Sarfraz Ahmed, Abdelbaset Mohamed Elasbali, Mohd Adnan, Asimul Islam, Md. Imtaiyaz Hassan, Dharmendra Kumar Yadav
International Journal of Molecular Sciences.2021; 22(22): 12162. CrossRef
Diagnosis and treatment of the early stages of diabetic polyneuropathy
V. N. Khramilin, A. N. Zavyalov, I. Yu. Demidova
Meditsinskiy sovet = Medical Council.2020; (7): 56. CrossRef

The Correlation between Central Obesity and Glucose, Lipid Metabolism and Macrovascular Complication in Elderly Type 2 Diabetes.: Eui Dal Jung, Jihyun Lee, Ho Sang Shon; Korean Diabetes J. 2007;31(4):343-350. Published online July 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.4.343

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17 Download
2 Crossref

Abstract PDF

BACKGROUND
Obesity is related to abnormal lipid metabolism and macrovascular complication and accumulated fat on the abdomen in elderly diabetic patients. The aim of this study was to compare elderly diabetic patients' body fat composition with middle-aged patients and evaluate the role of central obesity on glucose and lipid metabolism and macrovascular complications in elderly type 2 diabetic patients. METHODS: We defined elderly patients who are over 65 years old and who waist circumference is over than 90 cm in men and 85 cm in women and waist-hip ratio (WHR) was over than 0.90 in men and 0.85 in women defined central obesity. % body fat were measured a bioimpedence analysis using DSM (Direct Segmental Measurement by 8-point electrode) method (Inbody 3.0, Biospace, Seoul, Korea) in two hundred two type 2 diabetes. Laboratory parameters such as fasting blood glucose, HbA1c, and lipid profile were included in this study and also investigated the macrovascular complication. RESULTS: 1) The ninety-five elderly diabetic patients, compared with middle-aged diabetic patients, were similar BMI and % of body fat but significantly increased waist circumference (P < 0.05) and WHR (P < 0.001). 2) In pearson's correlations, waist circumference was correlated with BMI (r = 0.927, P < 0.001), WHR (r = 0.851, P < 0.001), % body fat (r = 0.519, P < 0.001), total cholesterol (r = 0.255, P < 0.05), triglyceride (r = 0.365, P < 0.001), and LDL-cholesterol (r = 0.271, P < 0.05) in elderly diabetic patients. And WHR was also correlated with BMI (r = 0.744, P < 0.001), waist circumference (r = 0.851, P < 0.001), % body fat (r = 0.425, P < 0.001), total cholesterol (r = 0.372, P < 0.001), triglyceride (r = 0.408, P < 0.001), and LDL-cholesterol (r = 0.386, P < 0.001). 3) The obese elderly diabetic patients had increased triglyceride, total cholesterol and LDL-cholesterol but not related with macrovascular complication compared with lean elderly patients. CONCLUSION: In elderly type 2 diabetic patients are more central obesity although the same weight compared with middle-aged patients. Waist circumference and WHR were highly correlated with body fat composition and lipid profile in elderly diabetes. In obese elderly patients have abnormal lipid profile but not more macrovascular complication.

Citations

Citations to this article as recorded by

Potential Benefits of Acupuncture and Herbs for Obesity-Related Chronic Inflammation by Adipokines
Ji-Youn Kim, Seon-Eun Baek, Rehna Paula Ginting, Min-Woo Lee, Jeong-Eun Yoo
Evidence-Based Complementary and Alternative Medicine.2020; 2020: 1. CrossRef
A Nationwide Survey about the Current Status of Glycemic Control and Complications in Diabetic Patients in 2006 - The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus -
Soo Lim, Dae Jung Kim, In-Kyung Jeong, Hyun Shik Son, Choon Hee Chung, Gwanpyo Koh, Dae Ho Lee, Kyu Chang Won, Jeong Hyun Park, Tae Sun Park, Jihyun Ahn, Jaetaek Kim, Keun-Gyu Park, Seung Hyun Ko, Yu-Bae Ahn, Inkyu Lee
Korean Diabetes Journal.2009; 33(1): 48. CrossRef

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