Effects of aldose reductase inhibitor treatment in diabetic polyneuropathy - a clinical and neurophysiological study.

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Abstract
The efficacy of treatment with an aldose reductase inhibitor (1,3-dioxo-1H-benz[de]isoquinoline-2(3H)-acetic acid, AY-22,284, Alrestatin) on peripheral nerve function in diabetic polyneuropathy was assessed. Patients (30) with long-standing diabetes and slight-to-moderate neuropathy participated in the double-blind placebo trial. Clinical examination, sensory threshold determinations for vibratory, tactile and thermal stimuli, conduction velocity measurements and studies of automatic function were performed to evaluate the treatment. Significant differences favoring Alrestatin over placebo were found for many of the measured variables; no changes occurred on placebo. The apparent improvement of neuropathy occurred despite persisting hyperglycemia. Aldose reductase inhibitor treatment may be of value in diabetic polyneuropathy and provide support for the sorbitol pathway hypothesis of diabetic polyneuropathy.