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Updated: Apr 16 2021


  • Snapshot
    • A 69-year-old man presents to your clinic with a chief complaint of changes in his vision. He has a past medical history of diabetes mellitus type II and medication non-compliance. The patient states that after a very large meal in which he consumed a family-sized bucket of chicken, a glass of maple syrup, and an entire wedding cake, he noticed that his vision became very blurry. He notes that this tends to happen whenever he eats a large meal.
  • Overview
    • Pathway
      • alternative method of trapping glucose in the cell
        • tissues with sorbitol dehydrogenase
          • liver
          • ovaries
          • seminal vesicles
          • lens (at low level of activity)
        • tissues without sorbitol dehydrogenase
          • Schwann cells
          • retina
          • kidneys
      • note: galactose can also be converted to an aldose
        • see Galactose Metabolism topic
    • Clinical relevance
      • prolonged hyperglycemia
        • commonly caused by uncontrolled diabetes mellitus
        • pathophysiology
          • glucose enters cells and is converted to sorbitol
            • in tissues without sorbitol dehydrogenase or low levels of activity
              • sorbitol trapped in cell and is osmotically active
        • presentation
          • pathology directly linked to which tissues have aldose reductase but lack sorbitol dehydrogenase
            • peripheral neuropathy
            • cataracts
            • retinopathy
          • all symptoms of chronic diabetes
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