Effect of propionyl-L-carnitine in the treatment of diabetic angiopathy: controlled double blind trial versus placebo

Diabetic angiopathy can be treated by medical or surgical means. In the initial stages of the disease (I and II according to Fontaine), pharmacological treatment aims at supplying ischaemic and therefore hypoxic regions with a sufficient quantity of energetic substrates for metabolic needs. A new method of treating peripheral vasculopathy was carried out in this study using propionyl-L-carnitine (PLC), a propionic ester of L-carnitine. The authors evaluated in a double-blind study the efficacy of chronic oral administration of PLC versus placebo. Twenty type II diabetic patients with peripheral angiopathy were enrolled in this study. They were divided into 2 groups of ten patients each. On termination of treatment, the ankle/arm pressure index, measured at rest, showed an improvement in the PLC treated group and a deterioration in the placebo group. The Windsor index, measured at 2, 5 and 10 min after exercise, showed a significant impairment in the PLC treated group with respect to the placebo group. The percent variation in walking distance, measured at various time intervals according to the protocol, showed a marked improvement in the PLC treated group. These results show that PLC significantly improves both walking distance autonomy and symptoms related to peripheral vasculopathy in diabetic patients. Like carnitine, PLC seems to act through a metabolic mechanism which results principally in preventing lactate formation in ischaemic tissue.