Epalrestat and Diabetic neuropathy

Diabetic neuropathy is one of the most common long-term complications in patients with diabetes mellitus, with a prevalence of 60-70% in the United States. It is a significant cause of morbidity and mortality, accounting for more hospital admissions than all other diabetic complications combined, and it is responsible for greater than 60% of nontraumatic amputations.

Epalrestatis a novel aldose reductase inhibitor which has been proven to have beneficial effects in diabetic neuropathy in many controlled clinical trials. It has been suggested that accumulation of sorbitol in certain cells occurring only in conditions of hyperglycemia and resulting in a hyperosmotic effect, may be involved in the pathogenesis of some diabetic complications. Epalrestat inhibits sorbitol production and prevents further complications. This agent has no influence on blood glucose concentrations.

Then, a placebo-controlled double-blind clinical study of epalrestat was carried out and the effectiveness of the drug against diabetic neuropathy documented.