Do you recommend Alpha Lipoic Acid to patients with diabetic polyneuropathy?  

Recommend is a strong word. I mention it to my patients as there's some 'evidence' supporting it. It has minimal side effects and virtually no risk, so it's worth a try. However, it's important to note that very few of my patients report any benefit from it.

Yes, because a few randomized studies have shown (small in my opinion) a positive effect on sensory symptoms and possibly other outcome measures like NIS score. I tell my patients that this is not a "cure" for diabetic neuropathy, but it may have a small benefit for positive sensory symptoms as an a...

I recommend ALA 600 mg daily or 300 mg BID to all my patients with diabetic polyneuropathy. Not only does it help with neuropathic pain, as cited by Dr. @Manousakis, but there is data to support that it may help with glucose control.

Although ALA 600 mg daily may lack abundant potency, most patients will achieve enough relief that they prefer to continue this safe treatment long-term.Also see Bönhof et al., PMID 30256929.

I use it frequently with my patients with varying degrees of success. Some come off other medicines like gabapentin. I have had a few cases with significant improvement in autonomic neuropathy.

For patients who prefer natural or alternative treatments or after chemotherapy, I usually recommend: B Complex CoQ10 Vitamin D Magnesium Acetyl Carnitine Lipoic Acid (comes in different formulas) I've been encountering more patients with B1 deficiency during my assessments. If a B1 defic...