Effect of an aldose reductase inhibitor on esophageal dysfunction in diabetic patients.
OBJECTIVE
Disorders of the digestive tract in diabetic patients are mainly ascribed to disorders of the vagus nerve. Although aldose reductase inhibitors (ARIs) have been shown to be effective against diabetic peripheral neuropathy, their effectiveness on diabetic digestive neuropathy remains to be evaluated. The aim of the present study is to examine the effect of an ARI on the esophageal dysfunction in diabetic patients by monitoring pH and motility of the esophagus.


METHODS
Eight type 2 diabetic patients with peripheral neuropathy were administered with the ARI epalrestat (150 mg/day) for 90 days, and esophageal pH and motility were monitored before and after the ARI treatment.


RESULTS
Parameters related to the gastroesophageal acid reflux and the esophageal motility, such as % time of pH<4, DeMeester score, duration of the longest reflux episode, reflux episodes longer than 5 min, ratios of peristaltic waves with the amplitude greater than 25 mmHg and ratios of effective peristalsis were remarkably improved by the ARI treatment.


CONCLUSIONS
Because the present study clearly demonstrated the effectiveness of an ARI on the esophageal dysfunction in diabetic patients, ARI may be useful for the treatment of diabetic digestive disorders.
Kinekawa
Fumihiko
F
Third Department of Internal Medicine, Kagawa University School of Medicine, Kita-gun, Kagawa, Japan.
Kubo
Fumiyoshi
F
Matsuda
Kazuya
K
Fujita
Yoko
Y
Kobayashi
Mitsuyoshi
M
Funakoshi
Fumi
F
Uchida
Naohito
N
Watanabe
Seishiro
S
Tomita
Tadataka
T
Uchida
Yoshihito
Y
Kuriyama
Shigeki
S
D000368:Aged; D000449:Aldehyde Reductase / Q000037:antagonists & inhibitors*; D048909:Diabetes Complications; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D015154:Esophageal Motility Disorders / Q000188:drug therapy* / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D004947:Esophagus / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D010528:Peristalsis / Q000187:drug effects; D012236:Rhodanine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D053778:Thiazolidines; D013997:Time Factors
D004791:Enzyme Inhibitors; D053778:Thiazolidines; C038131:epalrestat; D012236:Rhodanine; D000449:Aldehyde Reductase