Mode of action of lipoic acid in diabetes

Abstract

Metabolic aberrations in diabetes such as hyperglycemia, ketonemia, ketonuria, reduced glycogen in tissues and reduced rates of fatty acid synthesis in the liver are corrected by the administration of lipoic acid. Dithiol octanoic acid is formed from lipoic acid by reduction and substitutes for Coenzyme A in several enzymatic reactions such as pyruvate dehydrogenase, citrate synthase, acetyl Coenzyme A carboxylase, fatty acid synthetase, and triglyceride and phospholipid biosynthesis; but not in the oxidation of fatty acids because of the slow rates of thiolysis of β-keto acyl dithioloctanoic acid. The overall effect of these changes in the key enzymic activities is seen in the increased rates of oxidation of glucose and a reduction in fatty acid oxidation in diabetes following lipoic acid administration.