Vol 10, Issue 8, 2017 Online - 2455-3891 Print - 0974-2441 EFFECT OF ALPHA LIPOIC ACID IN TREATMENT OF TYPE 2 DIABETES PRIYAMBADA PANDA 1 *, SITANSU KUMAR PANDA 2 , TAPASWINI MISHRA 1 1 Department of Physiology, Institute of Medical Sciences & SUM Hospital, Bhubaneswar, Odisha, India. 2 Department of Anatomy, Institute of Medical Sciences & SUM Hospital, Bhubaneswar, Odisha, India. Email: purabipriyambada@gmail.com Received: 03 April 2017, Revised and Accepted: 03 May 2017 ABSTRACT Objective: Antioxidant probably can prevent the progression and complications of Type 2 diabetes mellitus (T2DM). Due to effectiveness of alpha lipoic acid (ALA) as an antioxidant, this study was done in T2DM patients to evaluate the effect of ALA on their diabetic status, lipid profile, and oxidative stress (OS) status. Methods: A total of 35 patients with diabetes were selected randomly who were under insulin treatment mainly and grouped as Group “A.” Another age- and sex-matched healthy controls selected grouped as “B.” Both groups supplemented with ALA (300 mg/day) for 6 months continuously. All parameters were tested before and after the supplementation. Results: There was a significant decrease in fasting blood sugar from 161 to 122 mg/dl in Group “A” and from 98 to 90 mg/dl in Group “B.” Postprandial blood sugar (PPBS) and glycosylated hemoglobin (HbA1c) levels also significantly decreased from 211 to 158 mg/dl and 8.81% to 7.2%, respectively, in Group “A.” PPBS levels significantly decreased from 130 to 124 mg/dl in Group “B,” but HbA1c% decreased insignificantly from 5.26% to 5.24% in Group “B.” Lipid profile parameters decreased in both groups except triglyceride level, which show insignificant relation in Group “B.” OS marker malondialdehyde significantly decreased from 1.967 to 1.592 nm/ml in Group “A” and from 0.613 to 0.472 nm/ml in Group “B.” Plasma antioxidant glutathione shows a significant increase in both groups from 2.117 to 2.405 µmol/L in Group “A” and from 2.631 to 2.811 µmol/L in Group “B.” Plasma nitric oxide also shows significant increase in both groups from 1.712 to 1.990 µmol/L and from 2.139 to 2.318 µmol/L, respectively. Conclusion: Therefore, ALA is a potent antioxidant and can be used against oxidative injury associate with T2DM. Keywords: Type 2 diabetes mellitus, Alpha lipoic acid, Oxidative stress markers. INTRODUCTION As a chronic metabolic disorder, diabetes mellitus (DM) characterized by hyperglycemia due to defect in secretion or action of insulin or both, this causes imbalance in carbohydrate and fat metabolism [1]. DM is mainly categorized into Type 1 and Type 2. Type 1 DM (T1DM) is primarily due to autoimmune pancreatic ß-cell destruction. Type 2 DM (T2DM) is the frequent form and is due to impaired insulin secretion or insulin resistance [2]. According to the Diabetes Atlas 2011, the incidence of diabetes is increasing and expected to reach from 366 million in 2011 to 552 million by 2030 [3]. Due to diversity of manifestation of disease and its complications, it causes a great human suffering physically, mentally, and even economically, even with the enormous available facilities to control the disorder [4]. In the disease progression, the prolonged exposure to hyperglycemia causes many long-term microvascular or macrovascular complications involving cardiovascular system, excretory system, nervous system causes diabetic cardiomyopathy, diabetic retinopathy, and neuropathy, which are prime cause of disability, morbidity, and premature death in T2DM [5,6]. Oxidative stress (OS) results insulin resistance in T2DM [7]. Hence, number of studies done to know the effect of antioxidant supplementation in T2DM treatment, where some found positive result [8-10], while others found none [11]. Alpha lipoic acid (ALA) a both fat and water soluble antioxidant may help in regenerating other antioxidants and make them active again so often termed as “universal antioxidant.” ALA might protect metabolic syndromes such as DM, improving insulin sensitivity and preventing distal sensory-motor diabetic neuropathy [12]. According to Blumenthal study, ALA in their experimental study improved the glycemic condition by acting on the liver [13]. However, there are some inconclusive evidences regarding its action in defending the OS level, improving the conditions of insulin deficiency and improvement of lipid profile level in T2DM patients. They are mostly done on animals [14,15]. As the T2DM incidence is increasing rapidly, the present study was undertaken to explore the effect of ALA supplementation on glycemic indexes, lipid profiles, and OS markers in T2DM patients. METHODS This was a prospective study including patients who were attending Endocrinology Department (both indoor and outdoor) and their biomolecular investigations were carried in Physiology Department and Biochemistry Department, IMS and SUM Hospital, Bhubaneswar. The institutional ethical committee approval was obtained. For this study, 35 patients suffering from T2DM were included in Group “A,” who were taking insulin as their main treatment. Moreover, 35 healthy participants were taken as controls, who were matched by age and gender, grouped as Group “B.” The study protocol was explained to the patients, and their written consent was obtained. All patients were supplemented by ALA capsules (133 mg), 2 capsules/day for 6 months continuously. • Inclusion criteria were patients with T2DM with fasting blood sugar (FBS) <250 mg/dl. Moreover, patients taking insulin as their main treatment • Exclusion criteria: Patients with T2DM whose FBS >250 mg/dl; patients with uncontrolled hypertension (blood pressure >140/90 mmHg in spite of antihypertensive drugs); patients with complications of diabetes including nephropathy, retinopathy, and neuropathy; patients with any history of myocardial infarction or cardiac intervention or clinically active cardiovascular diseases; patients © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2017.v10i8.18869 Research Article