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The diagnosis is usually made after an incidental discovery of unexplained elevation of liver enzyme levels or when steatosis is noted on imaging (e.g., ultrasonography)

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Administration of lipoic acid (200 to 1,800 mg/day for 2 weeks to 1 year), alone or together with other nutrients, was found to lower fasting blood glucose and insulin concentrations, insulin resistance, and blood HbA1c concentration a marker of glycemic control over the past few months (60)

The manufacture and handling of such dosage forms has so far been much more difficult due to the high hygroscopicity of L-carnitine