The polyol pathway has been implicated in the pathogenesis of diabetic complications. To determine the activity of the polyol pathway, the ratio of erythrocyte sorbitol to blood glucose, which reflects aldose reductase activity, was evaluated in 329 patients with type II (non-insulin-dependent) diabetes mellitus and in 100 nondiabetic age-matched control subjects. Although erythrocyte sorbitol levels were markedly elevated, sorbitol-glucose ratios were significantly lower in diabetic patients than in nondiabetic subjects. Sorbitol-glucose ratios in diabetic patients decreased progressively as blood glucose and hemoglobin A1c (HbA1c) levels increased. Sorbitol-glucose ratios were also studied during a 75-g oral glucose tolerance test. Ratios were again lower in diabetic patients than those in nondiabetic subjects and significantly decreased 120 min after glucose loading. The ratio in diabetic patients also fell with increasing age of the patients. In diabetic patients with neuropathy, retinopathy, or nephropathy, however, sorbitol-glucose ratios were significantly higher than in those without these complications; ratios increased further as complications became more severe. Our findings suggest that the affinity of aldose reductase for glucose in patients with diabetic complications may be increased and that the polyol pathway is implicated in the pathogenesis of diabetic complications.
Skip Nav Destination
Article navigation
Original Articles|
May 01 1990
Clinical Significance of Erythrocyte Sorbitol—Blood Glucose Ratios in Type II Diabetes Mellitus Free
Kaoru Aida, MD;
Kaoru Aida, MD
Department of Internal Medicine, University of Yamanashi Medical School
Yamanashi, Japan
Search for other works by this author on:
Masato Tawata, MD, PhD;
Masato Tawata, MD, PhD
Department of Internal Medicine, University of Yamanashi Medical School
Yamanashi, Japan
Search for other works by this author on:
Hideo Shindo, MD;
Hideo Shindo, MD
Department of Internal Medicine, University of Yamanashi Medical School
Yamanashi, Japan
Search for other works by this author on:
Toshimasa Onaya, MD, PhD
Toshimasa Onaya, MD, PhD
Department of Internal Medicine, University of Yamanashi Medical School
Yamanashi, Japan
Search for other works by this author on:
Address correspondence and reprint requests to Dr. Toshimasa Onaya, Third Department of Internal Medicine, University of Yamanashi Medical School, Tamaho, Yamanashi 409–38, Japan.
Diabetes Care 1990;13(5):461–467
Article history
Received:
May 25 1988
Revision Received:
February 08 1989
Accepted:
February 08 1989
PubMed:
2351023
Citation
Kaoru Aida, Masato Tawata, Hideo Shindo, Toshimasa Onaya; Clinical Significance of Erythrocyte Sorbitol—Blood Glucose Ratios in Type II Diabetes Mellitus. Diabetes Care 1 May 1990; 13 (5): 461–467. https://doi.org/10.2337/diacare.13.5.461
Download citation file: