It means that the efficacy of monotherapy could be offset by other signaling pathways
However, any additive glucose-lowering supplement is worth flagging with your prescriber when titrating your regimen
However, in a more recent randomized, placebo-controlled study in 102 subjects, daily supplementation with 600 mg of lipoic acid (+/- 800 mg of vitamin E [-tocopherol]) for 16 weeks had no effect on fasting blood glucose, fasting blood insulin, or a measure of insulin resistance called the homeostatic model assessment of insulin resistance (HOMA-IR) index (59)
Take L-carnitine and L-carnosine, for instance: on the surface, they sound very similar but when you look closely, some critical differences make them stand apart
"N-acetylcysteine in depressive symptoms and functionality: a systematic review and meta-analysis." J Clin Psychiatry