Time：2023-02-06 03:12:20 source：psychiatricethics.com author：Leisure vacation Read：115次

Epalrestat cannot lower blood sugar, but many diabetics are using it, why?

A friend with diabetes told Hua Zi that there are many diabetic friends around him who are using epalrestat, but this drug cannot lower blood sugar. Why is everyone using it? Does he need to use it? Hua Zi said that epalrestat has a special status in the treatment of diabetes. Although it cannot lower blood sugar, it can prevent and treat complications such as peripheral neuropathy and diabetic foot caused by diabetes, as well as vascular disease and kidney disease caused by diabetes. Both have therapeutic effects, so doctors recommend long-term use in diabetic patients who are at risk of complications.

First, the damage of high blood sugar to the body

The mechanism of the damage of high blood sugar to the human body has a theory of "sorbitol accumulation". When human blood sugar is normal, the main metabolic pathway of glucose is through aerobic metabolism to generate carbon dioxide and water or anaerobic glycolysis to generate lactic acid, and at the same time to provide energy for the body. However, when the blood sugar of the human body is too high, a large amount of glucose will undergo bypass metabolism and be converted into sorbitol through the action of aldose reductase. The accumulation of sorbitol in nerve cells and epithelial cells will cause toxic reactions, leading to apoptosis, which will lead to nerve and blood vessel damage, and induce various diabetes complications. Therefore, if diabetic patients control their blood sugar, they can reduce the production of sorbitol and avoid or reduce the complications of diabetes.

II. What does epalrestat do

Epalrestat is currently the only drug that can inhibit aldose reductase , can reduce the glucose bypass metabolism in hyperglycemic state and reduce the production of sorbitol. Therefore, epalrestat can reduce the toxic reaction caused by the accumulation of sorbitol, reduce cell damage, promote the self-repair of cells, improve subjective symptoms and neurological dysfunction, and have a good therapeutic effect on vascular disease and neuropathy caused by diabetes. For those with poor long-term blood sugar control and a higher risk of diabetic complications, epalrestat can be used to prevent the occurrence of complications. Diabetic patients who have developed complications, such as peripheral neuropathy (hands and feet numbness, chills, paresthesia, etc.), diabetic foot, cardiac autonomic nerve damage (arrhythmia, palpitation, chest tightness, etc.), diabetic vascular damage, diabetic nephropathy, etc., Treatment with epalrestat. But everyone must understand that although there is epalrestat to reduce sorbitol and prevent complications, the core of diabetes treatment is to control blood sugar.

3. What should I pay attention to when using epalrestat

1. Take the medicine before meals: the usual dose is 50 mg each time, 3 times a day Second, take the medicine before meals. The elderly and those with liver and kidney insufficiency should reduce the dose as appropriate. 2. Effects on liver and kidney: After oral absorption of epalrestat, it is mainly distributed in the digestive tract, liver, and kidney. Abnormal liver and kidney function may occur. Occasionally, bilirubin, aminotransferase (AST, ALT), and creatinine increase high. Overdose is not recommended to avoid liver and kidney damage. 3. Urine discoloration: The metabolites of epalrestat will be excreted through the kidneys, and the urine will appear reddish-brown during taking. Don’t worry if you see abnormal urine color, it can return to normal after stopping the drug. During taking the medicine, the bilirubin and ketone bodies in the urine will increase, which will interfere with the urine examination. 4. Adverse reactions: Occasionally, allergic reactions such as erythema, rash, itching, etc. are seen, and the drug should be discontinued if allergies occur. It may cause gastrointestinal reactions such as diarrhea, nausea, vomiting, loss of appetite, etc., but the reactions are usually mild and do not affect the medication, and can return to normal after stopping the medication. Headache, dizziness, fatigue, drowsiness and other adverse reactions are rare. To sum up, although epalrestat cannot lower blood sugar, it can reduce the production of sorbitol and has a good preventive effect on diabetic complications. People with substandard blood sugar control, potential risk of diabetic complications or those who have already developed diabetic complications can take epalrestat for a long time to prevent and treat a variety of diabetic complications. The drug should be used under the guidance of a doctor. If you have any doubts about the drug, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.

(责任编辑：Depression)

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