| Objective:In the last few decades,the occurrence of type 2 diabetes has rapidly increased internationally. However, diabetes is also characterized by dramatic microangiophatic complications, such as retinopathy, nephropathy, and neuropathy Diabetic neuropathy represents a major health problem, as it is responsible for substantial morbidity, increased mortality, and impaired quality of life. Near-normoglycemia is now generally accepted as the primary approach to prevention of diabetic neuropathy, but is not achievable in a considerable number of patients. Recent evidence suggests that glucose overload may damage the cells through oxidative stress. This is currently the basis of the"unifying hypothesis"that hyperglycemia-induced oxidative stress may account for the pathogenesis of all diabetic complications. It has been suggested that the following four key biochemical changes induced by hyperglycemia are all activated by a common mechanism—overproduction of superoxide radicals:increased flux through the polyol pathway, increased formation of advanced glycation end products, activation of protein kinase C, increased shunting of excess glucose through the hexosamine pathway.Consequently,antioxidants such asα-lipoic acid have been shown to improve experimental diabetic neuropathy. . Chemical studies have indicated that ALA scavenges hydroxyl radicals, hypochlorous acid, and singlet oxygen. ALA exerts antioxidant effects in biological systems not only through direct ROS quenching but also via transition metal chelation. ALA has been shown to possess a number of beneficial effects both in the prevention and treatment of diabetes in experimental conditions.In this studay the possiblility that the clinical effect of DPN withα-lipoic acid. Method:According to the 1999 WHO revision of the diabetes diagnostic criteria, choose have already been confirmed of Diabetic patient, meanwhile according with the following condition:(1) Fasting blood glucose<8.0mmol/L by insulin,HbA1c<10%;(2)Limbs sensory disturbance, appeared numbness,pain,burning sensation,paresthesia and so on, achilles tendon reflex attenuated or disappeared;(3)EMG reveals that nerve conduction velocity rev down;(4) Ruled out other causes of peripheral neuropathy. 80 patients with DPN were randomly divided into 2 groups. Treatment group 38 cases, 20 males and 18 females, aged 19-65 years, mean age 42.6±2.6 years, duration of diabetes 2 years -20 years, average 8.4±5.4 years. The control group, 42 cases, 20 males and 22 females, aged 21-67 years, mean 44±6.5 years, duration of diabetes 2.5-20 years, average 8.1±6.3 years. Insulin glucose-lowering in both groups,after blood glucose control over standards,the treatment group given ALA 600 mg + 0.9% saline 100ml intravenously guttae,1/d;control group was given mecobalamin1.0mg + 0.9% saline 20 ml intravenous injection, 1/d. Duration of treatment 14d. Compare before-treatment to after-treatment about improvement of clinical symptoms, neurological symptom score, motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), urinary albumin, plasma endothelin and C-reactive protein.Result:The baseline data of two groups of before treatment showed no statistically significant differences.After 14 days treatment, the nerve conduction velocity and neurological score of mecobalamin group increased significant, P <0.05. However, before-treatment and after-treatment, FBG and PBG2h,CRP,ET,mALB show no significant difference. In ALA treatment group, fasting and 2h postprandial blood glucose show no significant difference before-treatment and after-treatment. ALA treatment group, after treatment the nerve conduction velocity increased significantly, P <0.05. ALA group before and after treatment, neurological symptom score, CRP, ET, mALB show significantly, P <0.05,. After treatment, nerve conduction velocity velocity comparison,α-lipoic acid group increased significantly compared with mecobalamin, P <0.05, statistically significant. ALA group, nerve conduction velocity and CRP, ET, mALB correlation analysis, correlation coefficient is negative, P <0.05.Conclusion:ALA and methylcobalamin can improve nerve conduction velocity of DPN patient,with the same therapy,the treatment effect of ALA is superior methylcobalamin on improving the nerve conduction velocity. But due to limited observation time, this study showed that ALA effected on blood glucose in a short time no significant difference, whether The drug has influence on blood sugar is still need long course of observational studies. while ALA speeded up nerve conduction velocity,it also redued microalbuminuria,plasma endothelin and C-reactive protein in patients with DNP, indicating that the role of ALA treatment associated with the improvement of the above factors.
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