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By inhibiting lipid peroxidation, ALA preserves membrane integrity and protects cells from oxidative injury, which is especially important in DPN, where oxidative damage is a significant pathological contributor [3,14]
Many patients are bothered by hyperpigmentation on their hands, feet, and knees as well
The classification also does not take into account heterozygosity, which results in a wider spread of residual enzyme activity, as well as the effect of compounding mutations which has been shown to synergistically decrease the catalytic activity and/or protein stability (34)
It also plays a role in immune function and mood regulation