The role of oral alpha-lipoic acid as an adjuvant antioxidant therapy in diabetic nephropathy among children and adolescents with type 1 diabetes: a randomized controlled trial

Abstract

Aim Evaluate the oxidant-antioxidant balance and the efficacy of Alpha-lipoic acid (ALA) as an adjuvant therapy for diabetic nephropathy (DN) among individuals with type 1 diabetes (T1D). Materials and methods A 3 months prospective randomized controlled trial including 50 participants with DN randomly allocated (1:1) to one of two arms; an interventional arm receiving 300 mg/day of ALA ( n = 25) and a non-interventional arm (n = 25). Initial assessments included HbA1c, urinary albumin excretion rate (UAER), malondialdehyde (MDA), and total antioxidant capacity (TAC). Baseline data was compared with 50 participants with T1D without DN and 50 healthy controls. Results T1D participants had significantly higher MDA and lower TAC levels compared to controls ( P < 0.01). Within the T1D cohort, participants with DN showed significantly higher MDA and lower TAC levels ( P < 0.01). MDA positively correlated with triglycerides ( r = 0.53), UAER ( r = 0.70), and HbA1c (r = 0.5) ( p < 0.01), while TAC negatively correlated triglycerides ( r = −0.41), UAER ( r = −0.88), and HbA1c ( r = −0.64) ( p < 0.01). After 3 months of ALA supplementation, significant reductions in HbA1c, UAER, and MDA were observed, along with an increase in TAC ( P < 0.01). Conclusion The study demonstrates that 3 months of ALA supplementation effectively reduced oxidative stress and UAER, demonstrating a potential role in protecting renal tissue from diabetes-induced oxidative damage.