Diabetic neuropathy

It has been generally accepted that diabetic neuropathy is associated with substantial morbidity and increased mortality, and that aldose reductase inhibitors are of potential therapeutic value, whereas the beneficial effect of strict insulin treatment is questionable. Contrary to these expectations, population-based studies now report only 6% occurrence of severe neuropathy among insulin-dependent diabetes mellitus patients. Also, intensified insulin treatment preserved conduction velocity for 5 years in a large group of insulin-dependent diabetes mellitus patients and reduced neuropathy development by 60%, whereas studies on aldose reductase inhibitors failed to produce any convincing therapeutic effect.