Alpha-Lipoic Acid, Carnosine, and Thiamine Improve Glucose Metabolism in Obese Diabetic Patients

by | Jun 10, 2019 | 2018, Alpha Lipoic Acid, Blood Sugar, Diabetes, Obesity, Pancreatic Health

Written by Angeline A. De Leon, Staff Writer. An individualized supplement of alpha-lipoic acid, carnosine, and thiamine was able to maximize the potential antidiabetic activity in type 2 diabetic recipients by effectively reducing glucose concentration, and potentially increasing insulin production from the pancreas.

diabetesType 2 diabetes involves high blood sugar resulting from impaired insulin secretion. This insulin resistance associated with diabetes is also accompanied by platelet dysfunction, resulting in increased platelet reactivity and aggregation 1, and ultimately higher risk of atherosclerotic vascular complications 2. Along with the presence of elevated oxidative stress levels, risk of cardiovascular disease in patients with type 2 diabetes is greatly increased 3. Among natural substances boasting anti-diabetic activity, alpha-lipoic acid (ALA, a vitamin-like antioxidant), thiamine (an essential B vitamin), and carnosine (a naturally occurring compound in brain and muscle tissue) are among the most potent. ALA is noted for its ability to enhance glucose uptake and protect β cells 4, while thiamine facilitates intracellular glucose metabolism 5. Carnosine, also noted for its antioxidant properties, is known for its role in attenuating advanced glycation end products and lipoxidation end products 6,7. Combining all three natural compounds into an individualized oral supplementation, a team of researchers in Greece (2018) performed a study 8looking at the potential benefits of ALA, carnosine, and thiamine on glycemic profile, insulin sensitivity, and platelet functionality in obese patients with type 2 diabetes.

A total of 82 obese (body mass index, BMI > 30 kg/m2) patients (mean age = 57+/- 5 years) with type 2 diabetes were enrolled in a randomized, double-blind, placebo-controlled trial in which they were randomized to receive either an individualized supplement (consisting of 7 mg ALA/kg body weight, 6 mg carnosine/kg body weight, and 1 mg thiamine/kg body weight) or matching placebo three times daily for eight weeks. At baseline and at the end of the study, researchers assessed BMI and body fat and collected fasting blood samples to determine insulin sensitivity and secretion (homeostatic model of insulin resistance, HOMA-IR; homeostatic model of insulin secretion, HOMA-β) and to measure reactive oxygen metabolites (d-ROMs test). Platelet aggregation experiments were also carried out to assess platelet aggregation response to adenosine diphosphate (ADP), platelet activating factor, arachidonic acid (ARA), epinephrine, collagen, and thrombin. The anti-platelet aggregation activity of ALA, carnosine, and thiamine was also individually evaluated using human and rabbit platelets.

At the end of 8 weeks, findings showed that the treatment group experienced significant reduction in mean glucose levels (from 135.7 +/- 19.5 to 126.5 +/- 16.8 mg/dL, p < 0.01) and in hemoglobin A1C (HbA1c, measure of average amount of glucose in blood) (from 8.3 +/- 1.4 to 6.0 +/- 2.2%, p < 0.05). The supplement group exhibited a significant 72% increase in HOMA-IR (p < 0.05), as well as a 112% increase in insulin secretion, based on HOMA-β (p < 0.05). After 8 weeks, d-ROMs was found to be 35% lower in the supplemented group and in the lower normal range (p < 0.05), while d-ROMs remained high for controls. Platelet aggregation showed significant reduction for the supplemented group at follow-up (p < 0.05), and ex vivo and in vitro experiments indicated that only ALA inhibited platelet aggregation by all pathways of aggregation (ADP and ARA pathways most sensitive to ALA activity; epinephrine and thrombin least sensitive).

Based on findings, it is concluded that body-weight-adjusted supplementation with ALA, thiamine, and carnosine can effectively reduce blood glucose, improve insulin sensitivity, and mitigate diabetes-related oxidative stress in obese, diabetic patients. Supplementation also significantly lowered platelet aggregation (likely through ALA, primarily), potentially reducing risk of blood clots, a vascular complication strongly linked to cardiovascular disease. Researchers note that the primary limitation of the current trial relates to the use of HOMA-IR and HOMA-β as indirect measures of insulin resistance and secretion. In addition to employing more direct measures of insulin response, future studies should also investigate the dose-response effects of such an individualized supplementation in order to determine optimal anti-diabetic activity.

Source: Karkabounas S, Papadopoulos N, Anastasiadou C, et al. Effects of alpha-lipoic acid, carnosine, and thiamine supplementation in obese patients with type 2 diabetes mellitus: a randomized double-blind study. Journal of Medicinal Food. 2018; 21(2): 1197-120. DOI: 10.1089/jmf.2018.0007.

© Mary Ann Liebert, Inc., and Korean Society of Food Science and Nutrition

Posted June 10, 2019.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

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