Am Fam Physician. 2025;111(2):119-120
Author disclosure: No relevant financial relationships.
DETAILS FOR THIS REVIEW
Study Population: Adults 18 years and older who have type 1 or type 2 diabetes with symptomatic diabetic peripheral neuropathy (DPN) diagnosed on the basis of clinical symptoms or electrophysiological studies
Efficacy End Points: Change in neuropathy symptoms, change in impairment
Harm End Points: Adverse events leading to cessation of treatment
| Benefits |
| None; alpha-lipoic acid showed little to no benefit on neurologic symptoms or impairment at 6 months and 24 months compared with placebo |
| Harms |
| None; alpha-lipoic acid showed little to no risk of adverse events leading to cessation of treatment compared with placebo |
Narrative: Patients with diabetes have insufficient insulin production (type 1) or insulin resistance (type 2). Diabetes is a leading public health concern; its prevalence is estimated to increase to approximately 10% of the world's population by 2030 and approximately 11% by 2045.1 Around one-third of patients with diabetes experience DPN, the most common complication of diabetes.2 The pathophysiology of DPN is not well understood and likely multifactorial, including direct effects of hyperglycemia, inflammation, and oxidative stress. DPN is a major risk factor for the loss or decrease of protective sensation and a significant risk factor for diabetic foot ulcerations and nontraumatic amputations.3
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