ALTERNATIVE THERAPEUTIC PRINCIPLES IN THE PREVENTION OF MICROVASCULARAND NEUROPATHIC COMPLICATIONS

Since the prevention of chronic diabetic complications by near normal metabolic control is not always achievable, alternative therapeutic pr inciples have been developed. The specific intervention at metabolic a bnormalities which seem to play a key role in the pathogenesis of comp lications has been shown to prevent the development of microangiopathy and neuropathy in experimental diabetes, e.g. inhibition of non-enzym atic glycation by aminoguanidine, inhibition of polyol pathway activit y by aldose reductase inhibitors, prevention of hypoxia and oxidative stress by vasodilators and radical scavengers such as cr-lipoic acid. Some of these drugs should soon be available for common clinical use.