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A 2018 systematic review and meta-analysis identified 20 randomized controlled trials (published between 2007 and 2017) that examined the effect of supplemental lipoic acid on markers of glucose utilization in 1,245 subjects with metabolic disorders (not limited to type 2 diabetes) (60)

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Moreover, the presence of diminished muscle mass and power, aberrant muscle quality characterized by increased fat or myosteatosis, electrolyte imbalances, malnutrition, subclinical myopathy, diminished motivation, memory, and concentration, alongside an array of mental health and sleep disorders directly linked to or associated with the underlying disease, further exacerbate, and contribute to fatigue in cirrhosis (9)

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