| Outcome Measures: |
Primary: monofilament test of both feet, 5.07 (10 gram) monofilament will be used to test loss of protective sensation of at 10 sites in each feet at baseline and after use of alpha lipoic acid. the score range from 0 (worst) to 10 (best), : through study completion, an average of 3months|Vibration Perception Threshold (VPT), VPT was evaluated using a 128-Hz tuning fork applied bilaterally at the tip of the great toe. Responses were categorized as abnormal (no perception of vibration),present (examiner perceives vibration \<10sec after patient reported disappearance of vibration perception) ,and reduced (examiner perceives vibration \>10 seconds after patient reported disappearance of vibration perception)., : through study completion, an average of 3 months|neuromuscular ultrasound, the cross sectional area of the posterior tibial nerve will be assessed in both sides at baseline and after use of alpha lipoic acid, : through study completion, an average of 3 months|concentration of Hemoglobin A1c, the participants were divided into two categories that include good glycemic control (HA1c≤7%), poor glycemic control (≥ HA1c 7 %),, : through study completion, an average of 3 months|serum concentrations of high density lipoproteins-cholesterol (HDL-C), A low HDL cholesterol level was defined as \<1.03 mmol/l( 40 mg/dl) for men and \<1.29mmol/L(50 mg/dl) for women, : through study completion, an average of 3 months|serum concentrations of low density lipoproteins-cholesterol (LDL-C), a patient of LDL-C equal or more than 3.3mmol/L (129mg/dl) is defined as dyslipidemic., : through study completion, an average of 3 months|ankle reflex, ranging from 0 (absent) to 4 (hyperactive with clonus), : through study completion, an average of 3 months|Measurement of nerve conduction velocity, sensory and motor conduction velocity are measured in meter/second in common peroneal and posterior tibial nerves on both sides at baseline and after use of alpha lipoic acid, : through study completion, an average of 3 months|measurement of Compound Muscle Action Potential (CMAP) amplitudes, amplitude is measured in micro or millivolts in common peroneal and posterior tibial nerves on both sides at baseline and after use of alpha lipoic acid, : through study completion, an average of 3 months|measurement of Compound Muscle Action Potential (CMAP) distal latency, distal latency measured in milliseconds and evaluated in common peroneal and posterior tibial nerves on both sides at baseline and after use of alpha lipoic acid, : through study completion, an average of 3 months |
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