Long-term effect of epalrestat on cardiac autonomic neuropathy in subjects with non-insulin dependent diabetes mellitus

Abstract

To evaluate the effect of long-term administration of an aldose reductase inhibitor on diabetic cardiovascular autonomic neuropathy, 22 subjects with non-insulin dependent diabetes mellitus (NIDDM, 11 men and 11 women, mean age; 64.8±7.8 years, duration of diabetes; 18.3±5.6 years) were administered epalrestat, one type of aldose reductase inhibitor, for 36 months. The changes in the coefficient of variation of the R-R interval (CV R R) during rest and the QTc interval were compared with 43 age-matched NIDDM (controls). During the study, the CV R R value gradually decreased in the controls, while it slightly increased in subjects treated with epalrestat. After 36 months, the CV R R value (2.31±1.09%) in subjects treated with epalrestat was significantly ( P<0.05) higher than that (1.84±0.75%) in the controls. There were no significant differences in QTc intervals in both groups. These results suggest that long-term administration of an aldose reductase inhibitor may be available for cardiac autonomic neuropathy in even relatively older diabetic subjects with long duration.