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It has been suggested that oxidative stress might worsen the complications of diabetes,[] whereas antioxidants may alleviate and impede mechanisms that cause diabetes at an early stage.[] L-carnitine is an amino acid-based substance that has an important role in the transport of long-chain fatty acids through the internal mitochondrial membrane.[ , , ] In tissues such as skeletal muscle and heart, which use fatty acids as the main fuel, it can be seen in high concentrations.[] Additionally, as literature suggests, in individuals with diabetes, plasma L-carnitine concentrations are low.[] In addition, abnormal metabolism of carnitine has been reported in individuals with diabetes, and the higher prevalence of carnitine deficiency in muscle tissues of PAD patients has also been observed.[ , , ] Carnitine deficiency has been shown to correlate with cardiomyopathy.[] Therefore, decreased carnitine levels may impair myocardial function.[ , ] It has been suggested that L-carnitine, especially with its antioxidant and lipid-lowering effects, may be able to reduce atherosclerotic lesions.[ , ] Moreover, oxidation of lipids accelerates the formation of free radicals, thus carnitine may prevent oxidative stress by inhibiting the peroxidation of membranes fatty acids.[] So, due to limited amounts of L-carnitine, fatty acids cannot enter the mitochondria to oxidize and produce ATP

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