EFFECT OF TREATMENT WITH AN ALDOSE-REDUCTASE INHIBITOR ON SYMPTOMATICCARPAL-TUNNEL SYNDROME IN TYPE-2 DIABETES

The aim of this study was to test the efficacy of the aldose-reductase inhibitor Tolrestat in the treatment of carpal tunnel syndrome in Typ e 2 diabetic patients. Seventeen patients were treated with Tolrestat (200 mg daily for 12 months) clinical and neurophysiological evaluatio ns were performed at baseline, 6 and 12 months; symptoms and blood glu cose control were assessed at baseline, 2, 6, and 12 months. Thirteen Type 2 diabetic patients suffering from symptomatic carpal tunnel synd rome served as controls. Neurophysiological studies showed improvement in the sensory conduction velocity of the median nerve between forefi nger and wrist (baseline 37.5 +/- 4.3 vs 6 months 41.3 +/- 5.7 ms(-1), p < 0.0005 and baseline vs 12 months 41.4 +/- 8.2 ms(-1), p < 0.005) but not between wrist and elbow. The terminal latency index of the med ian nerve was unchanged. Paraesthesiae and pain improved in terms of i ntensity and frequency. Blood glucose control was not significantly ch anged. We conclude that treatment of this case series with Tolrestat a ppears to produce beneficial effect on the outcome of carpal tunnel sy ndrome in diabetic patients.