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Sorbitol: a hazard for diabetics?

Today's advanced treatments have transformed the less severe form of diabetes (type 2) from the rapid killer it once was to a disease which can be readily controlled. But with that control have come increasing numbers of long-term complications -- problems that never before had time to develop.

The enzyme that causes problems is called aldose reductase. In the body, it converts glucose into a related sugar called sorbitol -- a process that takes place to a small extent in all of us, even though it serves no known purpose. Conversion of glucose to sorbitol is greatly accelerated in diabetics, and that can cause dangerous complications over time. Since sorbitol can't exit from your cells very fast, and is not used in the body, it accumulates and attracts water. This causes the cells to swell, which can result in nerve, eye, kidney and blood vessel damage, as well as development of cataracts.

Up to this point, medical research has focused on more and more precise means of controlling blood glucose levels as the way to head off long-term complications of diabetes. Some progress has been made, and new high technology methods of delivering insulin to the body may achieve that goal. But on a more immediate and practical level, diabetics still have unavoidably large changes in blood glucose, and drugs to reduce levels of sorbitol by inhibiting the aldose reductase enzyme are viewed as a simpler, more effective way to achieve the same result.

The dangers of excess sorbitol accumulation seem clear. The American Diabetes Association reports that diabetes is the number one cause of blindness in the U.S., accounting for 5,000 new cases yearly, and that diabetes is the direct cause of some 20,000 amputations each year because of circulatory problems and infections.

No nerve in the body is exempt, and the results are often tragic. The damage initially shows up as a tingling sensation in the extremities which can progress to numbness. Diabetes can severly injure themselves and feel nothing.

An unanswered question: should diabetics avoid sorbitol-containing sugar substitutes?

A prudent diabetic would avoid all such alternative substances. Many diabetics experience an increase in blood sugar levels when exposed to any sweet -- original or substitute.
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Publication:Nutrition Health Review
Date:Jun 22, 1993
Words:368
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