Effect of Aldose Reductase Inhibition on Resistance to Ischemic Conduction Block in Diabetic Subjects
- David E Price, MD, MRCP,
- Shakir M Alani, MB, MRCP and
- John K Wales, MD, FRCP
- Address correspondence and reprint requests to Dr. David E. Price, Leicester General Hospital, Leicester LE5 4PW, UK.
Abstract
Objective To study the effect of aldose reductase inhibition with ponalrestat on resistance to ischemic conduction block (RICB) in diabetic subjects.
Research Design And Methods Twenty-one healthy diabetic subjects without neuropathy were studied. Subjects were randomized to take either a double-blind trial of 600 mg ponalrestat or placebo once daily for 6 wk. The median nerve action potential (MNAP) and conduction velocity (NCV), before and after 20 min of forearm ischemia, were measured at the start and finish of the study.
Results RICB (MNAP remaining after ischemia) decreased from 39.5 to 29.4% in the ponalrestat-treated group (P < 0.05) and increased from 48.1 ± 10.2 to 49.5 ± 6.5% in the placebo-treated group. MNAP and NCV were unchanged in both groups.
Conclusions Aldose reductase inhibition with ponalrestat partly reverses RICB in diabetes, perhaps by improving nerve hypoxia or reducing nerve energy substrates.
- Received June 25, 1990.
- Accepted December 10, 1990.
- Copyright © 1991 by the American Diabetes Association
