부산대학교 도서관

The hypothesis that the metabolic effects of hyperglycemia on nerve function are mediated by the potential role of polyol pathway activity was assessed using an aldose reductase (AR) inhibitor in diabetic patients.We studied the effects of ONO-2235-a new AR inhibitor-on diabetic neuropathy in 21 patients (12 men and 9 women).During 12 weeks of treatment with AR inhibitor (300mg/day or 600mg/day), significant improvement in ulnar MNCV and SNCV was observed and this was in good correlation with the sorbitol content in red cells. Improvement in subjective signs such as pain and numbness was also found within 2 weeks of treatment. Either objective or subjective symptoms were improved in 76% of our cases. There was no significant difference between the two groups treated with ONO-2235. However, on discontinuation of the medication, both nerve conduction velocity and subjective signs were again impaired more significantly in the group given 300mg/day. At a dose of 600mg/day, the continuation of the effects was observed for longer period compared with the lesser dose. None of these effects of the AR inhibitor were related glycemic control.Our findings suggest that the possible role of the polyol pathway in the pathogenesis of diabetic neuropathy was clarified and that AR inhibitors may become an important tool in the treatment of diabetic neuropathy.