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Purpose: To evaluate the effect of oral alpha-lipoic acid (ALA)?±?palmitoyl-ethanolamide (PEA) on neuropathic symptoms in patients with diabetic peripheral neuropathy (DPN) and to identify factors related to the efficacy of the treatment. Methods: This is a retrospective observational pilot study evaluating 49 patients with diabetes and positive Neuropathy Symptoms Score (NSS). Clinical and biochemical variables, including NSS, were compared between untreated patients and patients treated with oral 600?mg/day ALA?±?600?mg/day PEA at baseline (first occurrence of NSS =?3) and at least 2 months after baseline. Number of days between treatment initiation and symptoms’ relief and related factors were also investigated. Results: Thirty subjects were treated with ALA?±?PEA and 19 subjects did not receive any specific treatment for neuropathy symptoms. Follow-up visits occurred after 98?±?46 days. NSS significantly decreased in patients treated with ALA?±?PEA (5.4?±?1.3 at baseline vs. 1.7?±?2.4 at follow-up, p?<?0.001), but not in untreated patients (p?=?0.164). Subjects treated with ALA?±?PEA reported a mean time from treatment initiation to symptoms’ relief of 18.4?±?9.0 days. The number of days of treatment needed for symptoms’ relief was inversely related to HDL-cholesterol levels (r?=?-0.503, p?=?0.010) and to eGFR (r?=?-0.428, p?=?0.033), whereas there was no significant relationship between time to symptoms’ relief and age, HbA1c, lipid profile and the severity of symptoms at baseline. Conclusions: This study documents that oral administration of ALA?±?PEA helps in controlling neuropathy symptoms in diabetes. Moreover, our data show that higher HDL-c levels and better renal function are associated to a faster therapeutic effect, suggesting them as biomarkers of response to therapy with ALA?±?PEA.

To determine whether the administration of small amounts of glucose through an oral spray device (GSD) facilitates weight loss in overweight/obese subjects involved in a lifestyle modification programme. We randomly assigned 56 overweight/obese subjects to either the treatment group (n= 32) or the control group (n= 24). All subjects in both groups followed a structured dietary programme of 6,280.2 kJ (1,500 kcal)/day and exercised minimum 150 min a week and were followed-up for a period of 60 days. Subjects assigned to the treatment group were asked to spray, during early symptoms of neuroglycopenia, 10 puffs by GSD. GSD is a device that delivers to the buccal mucosa 50 mg of glucose per puff. A mean weight loss of 3.5 ± 3.0 kg in GSD-treated group compared to 1.7 ± 2.1 kg in control group (p= 0.01) was observed. Significant differences regarding reduction of BMI (−1.3 ± 1.0 vs −0.7 ± 0.8 kg/m2; p= 0.01) and waist circumference (−3.5 ± 3.2 vs −0.9 ± 3.5 cm; p= 0.02) were also detected. A short-term use of GSD, in association with dietary restriction and exercise, is helpful in improving weight loss and in reducing waist circumference in overweight/obese subjects.