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It is not an FDA-approved drug for systemic therapeutic use

Birch-Machin MA, Turnbull DM (2001) Assaying mitochondrial respiratory complex activity in mitochondria isolated from human cells and tissues

Suspected side effects from medicines including those received as part of a clinical trial can be reported to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk

Although these clinical studies did not report the mechanisms underlying the renal graft protection by ALA, it is not wrong to suggest that the protective mechanisms by ALA against renal IRI as discussed in section 3.2 above, account for the observed renal graft protection and the improved outcomes of kidney transplantation since IRI is a major contributor to the development of post-transplant complications including renal graft rejection

So were always going to favor the GLP medications before adding prandial insulin, but a lot of times insulin is the best option for our patients