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Acetyl L-carnitine is a modified (acetylated) form of L-carnitine that can pass through the blood-brain barrier, which L-carnitine cannot do

Peripheral Neuropathy Diabetic Neuropathy Guidelines from the American Society of Pain and Neuroscience (ASPN) state that, although dietary supplements including acetyl-L-carnitine may have a role in managing painful diabetic neuropathy, there is insufficient high-quality evidence comparing ALCAR to typical pharmacologic drugs, and there is not enough information about safe dosing, to recommend for or against its use [7][24]

McHugh JC, Tryfonopoulos D, Fennelly D, Crown J, Connolly S

Int J Gynecol Obstetr