N-acetylcysteine (NAC) and alpha-lipoic acid (ALA) are highly complementary nutrients, critical to cellular function and protection, and management of hyperglycemia associated damage. NAC drives the synthesis of the cellular antioxidant glutathione, often depleted in diabetes, cardiovascular disease, and those with increased oxidative stress.1,2 Additionally, glutathione is needed for the detoxification of many persistent organic pollutants, which have emerged as powerful contributors to diabetes and the metabolic syndrome.3 Clinical trials have shown that NAC restores intraplatelet glutathione levels among diabetics, a marker of atherothrombotic risk, and reduces homocysteine and improves endothelial function in coronary artery disease.4,5,6
ALA, in turn, recycles antioxidant nutrients such as vitamin C and glutathione, and is a cofactor for several mitochondrial enzymes as well as glutathione reductase.7 It improves glycemic control and insulin sensitivity in type 2 diabetics, endothelial function among individuals with impaired glucose tolerance, and enhances weight loss among obese subjects.8,9,10 It has a well-recognized benefit for the prevention and treatment of peripheral neuropathy among diabetics, improving both symptoms and objective markers of disease, such as nerve conduction velocity.11,12 Its antioxidant and neuroprotective effects may also provide protection against neurodegeneration, and a range of oxidant-associated diseases.13,14
