Aldose reductase inhibitors in the treatment of diabetic peripheral neuropathy: a review.
OBJECTIVE
The purpose of this article was to examine how aldose reductase (AR) inhibitors are used in the prevention and treatment of peripheral neuropathy in diabetes, specifically focusing on efficacy.


METHODS
Medline searches were used to identify clinical trials investigating AR inhibitors and their proposed mechanism of action, efficacy, and adverse effects. Additionally, the references of the articles returned by the Medline search were examined for pertinent publications.


RESULTS
Three AR inhibitors were selected for review. Modest improvements in the preservation and restoration of nerve conduction velocities were reported in the studies. Additionally, patients reported improvements in the subjective symptoms associated with diabetic peripheral neuropathy. Adverse effects for the studied agents were minimal or not reported.


CONCLUSIONS
Given the mechanism by which diabetic peripheral neuropathy can result, targeting the polyol pathway as a method of treatment appears promising, yet the efficacy of newer AR inhibitors is still to be proven. Currently, these agents are not marketed in the United States. As newer studies emerge, diabetes educators will learn more about their efficacy and safety in preventing and treating diabetic peripheral neuropathy.
Schemmel
Kate E
KE
Mercy Medical Center, Dubuque, IA 52001, USA.
Padiyara
Rosalyn S
RS
D'Souza
Jennifer J
JJ
D000449:Aldehyde Reductase / Q000037:antagonists & inhibitors*; D002986:Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000188:drug therapy* / Q000517:prevention & control; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D048289:Imidazolidines / Q000009:adverse effects / Q000494:pharmacology; D015337:Multicenter Studies as Topic; D009431:Neural Conduction / Q000187:drug effects; D011108:Polymers / Q000378:metabolism; D011719:Pyrazines / Q000009:adverse effects / Q000494:pharmacology; D012236:Rhodanine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000494:pharmacology; D013141:Spiro Compounds / Q000009:adverse effects / Q000494:pharmacology; D053778:Thiazolidines / Q000009:adverse effects / Q000494:pharmacology; D014481:United States
D004791:Enzyme Inhibitors; D007004:Hypoglycemic Agents; D048289:Imidazolidines; D011108:Polymers; D011719:Pyrazines; D013141:Spiro Compounds; D053778:Thiazolidines; C024617:polyol; C038131:epalrestat; D012236:Rhodanine; C077139:fidarestat; D000449:Aldehyde Reductase; C115070:ranirestat