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VOLUME 2 , ISSUE 1 ( January-March, 2016 ) > List of Articles


Touching Greater Horizons in the Management of Diabetic Neuropathy: Epalrestat in Advanced Role

Manish Maladkar, Chitra Tekchandani, Aakash Siddhanti

Citation Information : Maladkar M, Tekchandani C, Siddhanti A. Touching Greater Horizons in the Management of Diabetic Neuropathy: Epalrestat in Advanced Role. J Med Sci 2016; 2 (1):10.5005/jp-journals-10045-0025.

DOI: 10.5005/jp-journals-10045-0025

Published Online: 01-06-2016

Copyright Statement:  Copyright © 2016; The Author(s).


How to cite this article

Maladkar M, Tekchandani C, Siddhanti A. Touching Greater Horizons in the Management of Diabetic Neuropathy: Epalrestat in Advanced Role. J Med Sci 2016;2(1):9-14.

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  1. 7th ed. 2015.
  2. Clinical profile of peripheral neuropathy in diabetes mellitus by nerve conduction study. Sch J Appl Med Sci 2014;2(6A:)1973-1977.
  3. National diabetes fact sheet: National estimates and general information on diabetes and prediabetes in the United States, 2011. Available from:
  4. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol 2012 Jun;11(6:)521-524.
  5. Diabetic neuropathy and oxidative stress: therapeutic perspectives. Oxid Med Cell Longev 2012.
  6. Oxidative stress in cancer biology and therapy. Dordrecht: Springer; 2012. p. 21-46.
  7. The activation of Akt/PKB signaling pathway and cell survival. J Cell Mol Med 2005 Jan-Mar;9(1:)59-71.
  8. Akt: A double-edged sword in cell proliferation and genome stability. J Oncol 2012;2012:15. Available from:
  9. Involvement of PI3K/Akt pathway in cell cycle progression, apoptosis, and neoplastic transformation: a target for cancer chemotherapy. Leukemia 2003 Mar;17(3:)590-603.
  10. Transcription-dependent and -independent control of neuronal survival by the PI3K– Akt signaling pathway. Curr Opin Neurobiol 2001;11:297-305.
  11. Insulin resistance in the nervous system. Trends Endocrinol Metab 2012 Mar;23(3:)133-141.
  12. Rescue and regeneration of injured peripheral nerve axons by intrathecal insulin. Neuroscience 2006 May;139(2:)429-449.
  13. NGF promotes cell cycle progression by regulating D-type cyclins via PI3K/Akt and MAPK/Erk activation in human corneal epithelial cells. Mol Vis 2012 Mar;18:758-764.
  14. Neuroprotective role of nerve growth factor in hypoxic-ischemic brain injury. Brain Sci 2013 Sep;3(3:)1013-1022.
  15. Epalrestat improves diabetic wound healing via increased expression of nerve growth factor. Exp Clin Endocrinol Diabetes 2013 Feb;121(2:)84-89.
  16. Nerve growth factor and diabetic neuropathy. Exp Diabesity Res 2003 Oct-Dec;4(4:)271-285.
  17. The mechanism of the transformation of glucose in fructose in the seminal vesicles. Biochimica et biophysica acta 1956; 22(1):202-203.
  18. Aldose reductase: new insights for an old enzyme. Biomol Concepts 2011 Apr;2(1-2):103-114.
  19. Molecular mechanisms in the pathogenesis of diabetic nephropathy: an update. Vascul Pharmacol 2013 Apr;58(4:)259-271.
  20. Mechanism of diabetic neuropathy: Where are we now and where to go? J Diabetes Investig 2011 Jan;2(1:)18-32.
  21. The importance of glutathione in human disease. Biomed Pharmacother 2003 May-Jun;57(3-4:)145-155.
  22. The antioxidant role of glutathione and N-acetyl-cysteine supplements and exercise-induced oxidative stress. J Int Soc Sports Nutr 2005 Dec;2(2:)38-44.
  23. Epalrestat increases glutathione, thioredoxin, and heme oxygenase-1 by stimulating Nrf2 pathway in endothelial cells. Redox Biol 2015;4:87-96.
  24. A prospective, open label, 24-week trial of methylcobalamin in the treatment of diabetic polyneuropathy. J Diabetes Mellitus 2012 Nov;2(4:)408-412.
  25. Methylcobalamin: a potential vitamin of pain killer. Neural Plast 2013;2013. Doi: 10.1155/2013/424651.
  26. Efficacy, safety, and tolerability of epalrestat compared to methylcobalamine in patients with diabetic neuropathy. Int J Diabetes Dev Ctries 2009 Jan;29(1:)28-34.
  27. Methylcobalamin effects on diabetic neuropathy and nerve protein kinase C in rats. Eur J Clin Invest 2011 Apr;41(4:)442-450.
  28. The preventive efficacy of methylcobalamin on rat peripheral neuropathy influenced by diabetes via neural IGF-1 levels. Nutr Neurosci 2010 Apr;13(2:)79-86.
  29. Long-term clinical effects of epalrestat, an aldose reductase inhibitor, on diabetic peripheral neuropathy. Diabetes Care 2006 Jul;29(7:)1538-1544.
  30. Epalrestat induces cell proliferation and migration in endothelial cells via mTOR activation through PI3/Akt signaling. Diabetol Int 2014 Jun;5(2:)105-111.
  31. Evaluation of efficacy and safety of epalrestat and epalrestat in combination with methylcobalamin in patients with diabetic neuropathy in a randomized, comparative trial. J Diabetes Mellitus 2013 Feb;3(1:)22-26.
  32. Post-marketing surveillance of epalrestat and methylcobalamin – Game changer in the management of diabetic neuropathy: an Indian perspective. Indian Pract 2014 Jan;66(12:)683-689.
  33. Endothelial dysfunction in diabetes the role of reparatory mechanisms. Diabetes Care 2011 May;34(2:)S285-S290.
  34. Epalrestat increases intracellular glutathione levels in Schwann cells through transcription regulation. Redox Biol 2013 Nov;2:15-21.
  35. Effect of aldose reductase inhibitor on cutaneous nerve fiber length in diabetic patients. Diabetes Care 2000 May;23(5:)705.
  36. Efficacy and safety of methylcobalamin, alpha lipoic acid and pregabalin combination versus pregabalin monotherapy in improving pain and nerve conduction velocity in type 2 diabetes associated impaired peripheral neuropathic condition. Ann Indian Acad Neurol 2014 Jan;17(1:)19-24.
  37. Comparison of pregabalin-methylcobalamin with gabapentin-methylcobalamin therapy in diabetic neuroma- thy: a prospective study on quality of life. Am J Pharm Health Res 2014;2(9):72-83.
  38. Efficacy and tolerability of a fixed dose combination of methylcobalamin and pregabalin in the management of painful neuropathy. N Am J Med Sci 2012 Nov;4(11:)605-607.
  39. Nortriptyline and gabapentin, alone and in combination for neuropathic pain: a double-blind, randomised controlled crossover trial. Lancet 2009 Oct;374(9697:)1252-1261.
  40. Morphine, gabapentin, or their combination for neuropathic pain. N Engl J Med 2005 Mar;352(13:)1324-1334.
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