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September 9, 1999

Alternative Therapies and Explanations, Complications

Question from New York, USA:

My Goddaughter is Type 1 diabetic since age 9. She is now 21. She has developed complications of neuropathy. She looked healthy till four months ago. Since then has lost a great deal of weight. She was 105; is now 74 pounds and extremely thin even for her small frame. She has been seen by countless specialists and admitted twice to hospital in the past month. I see no improvement. She barely eats because she gets nauseous. I read that lipoic acid can help neuropathy tremendously and that it's approved for Diabetic Neuropathy as treatment in Germany. Why is the FDA dragging its feet in the U.S. on this megavitamin? Can her father buy it for her and give it to her immediately? We are at the point of panic! We don't know what else to do. All doctors say is take Carnation for breakfast or Ensure or multi-vitamin. That doesn't sound hopeful to us. Please help as soon as possible! She is so thin and fragile-looking now.


Alpha lipoic acid is an antioxidant that is a cofactor for some of the enzymes concerned with energy metabolism. It has been used in Europe, particularly in Germany, primarily for the treatment retinal vascular complications but also for diabetic neuropathy. As you know it is not yet approved as a drug in the US. It is available in most health food stores; but erratically on supermarket shelves. The unit dose as supplied however is much smaller than that recommended in the European clinical trials like ALADIN.

Most studies in the U.S. have been with animals; but recently NATHAN has been authorised which is a combined North American and Europaean clinical trial designed to clarify the rather ambivalent conclusions of earlier studies. I think it would be unreasonable to blame the FDA for foot dragging; they are constantly under great pressure to approve new drugs without full clinical trials, and of course drug companies sometimes hesitate to incur the huge expense of full testing unless a product looks extremely promising.

Without having a lot more information it would be inappropriate for me to make any specific suggestions via e-mail, but it does seem to me that the family needs to have a conference with your goddaughter’s diabetic team to review the situation as fully as possible and to discuss with them exactly what they think the problems are and what is being done for them. It is even possible because of the stress involved, that the doctors may feel that they have already done this; but that the realities have not in fact been communicated. Sometimes when this is the case an experienced medical social worker can be the best person to help not only the family, but your goddaughter as well.


[Editor’s comment: For research links, see:

Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials.
Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial.