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Alpha-Lipoic Acid, Carnosine, and Thiamine Supplementation in Type 2 Diabetes

7/16/2019 12:21:25 PM
diabetesType 2 diabetes is characterized by insulin resistance and hyperglycemia, which contribute to the formation of reactive oxygen species, increased platelet aggregation, and a higher risk of cardiovascular disease. Multiple nutritional supplements have been evaluated in the context of type 2 diabetes, including alpha-lipoic acid (ALA), carnosine, and thiamine.

Study examines ALA, carnosine and thiamine combination for diabetes management

Previous studies have shown that ALA prevents beta cell destruction, enhances glucose uptake, and slows the development of diabetic complications. Carnosine exerts antioxidant effects and has been shown to suppress the production of advanced glycosylated end products. Thiamine is a coenzyme that is essential for glucose metabolism. The combined effects of these 3 supplements were evaluated in a double-blind, randomized controlled trial that was published in the Journal of Medicinal Food in 2018.
The study involved 82 obese patients with recently diagnosed type 2 diabetes. Patients were randomized to take supplements or a placebo for 8 weeks. The supplements were dosed according to body weight, providing 7 mg/kg of ALA, 6 mg/kg of carnosine, and 1 mg/kg of thiamine 3 times per day. Biochemical assessments were measured at baseline and the end of the trial.

Supplementation of ALA, carnosine and thiamine improved blood test results

Results showed that the patients taking the supplements experienced a significant decrease in fasting glucose levels from baseline to 8 weeks. Fasting glucose levels dropped by 14%, from a mean of 135.7 mg/dL to a mean of 126.5 mg/dL (p<.01). Hemoglobin A1c (HbA1c) also dropped in the supplementation group, from a mean of 8.3% to a mean of 6.0% (p<.05). Fasting glucose and HbA1c remained unchanged in the placebo group. Finally, serum hydroperoxide level (a marker of oxidative stress) dropped significantly with supplementation yet stayed extremely high in the placebo group.
In conjunction with the improvements in fasting glucose, HbA1c, and oxidative stress, the supplementation group experienced a significant increase in the homeostatic model assessment of insulin resistance (HOMA-IR) and a steep increase in the secretion of insulin (from 3.6 microIU/L at baseline to 6.8 microIU/L after 8 weeks). No significant changes in HOMA-IR or insulin secretion were observed in the placebo group.
Supplementation had no significant effect on the lipid profile, electrolyte levels, or biochemical tests related to kidney, liver, or thyroid function. The only other pertinent finding from this study was that ALA inhibited platelet activity in an ex vivo assessment in human and rabbit platelets. 

Study concludes ALA, carnosine, thiamine increase insulin production

The authors of the study concluded that supplementation with ALA, carnosine, and thiamine reduced glucose concentrations and oxidative stress in type 2 diabetics by increasing the production of insulin from the pancreas. The advantages of each supplement and optimal dosages will need to be evaluated in future studies.      
Karkabounas S, Papadopoulos N, Anastasiadou C et al. Effects of α-Lipoic Acid, Carnosine, and Thiamine Supplementation in Obese Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blind Study. J Med Food. 2018; 21: 1197-1203.

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