Anyone have info on new med Ranirestat ? It is supposed to arrest progress of PN and possibly reverse some damage. I think its in trial at Cornell Presbyterian hospital .

Hi Flsun01 and welcome to the forum.

Maybe I can help a little with your question but the synopsis below is not intended to be comprehensive or all inclusive, rather some highlites and links to other leading sites. You're correct that the drug is in trials (now Phase III) at Cornell-Weill Presbyterian Hospital in NY. Hope this helps a little.

http://care.diabetesjournals.org/cgi/reprint/29/1/68


Ranirestat is a potent aldose reductase inhibitor (ARI) in development at Dainippon Pharma (Japan) to treat diabetic sensorimotor polyneuropathy (DSP). ARI’s are thought to act by inhibiting the polyol pathway leading to nerve damage. This is important because in diabetics prolonged hyperglycemia exacerbates ADR activity which in turn leads to increased conversion of glucose to polyols, e.g. sorbitol. Accumulation of sorbitol and fructose in nerve cells leads to damage.

The initial phase II study evaluated patients randomized at 5mg/day and 20mg/day and was 12 weeks which was extended to 60wks to further assess efficacy of the treatment program.

Ranirestat was further evaluated in a small (~90 patient population) multi-center, double-blinded, randomized trial to assess the efficacy of a higher dose – the study was conducted at Toronto General Hospital, Toronto, Canada.

In the initial study there were significant reductions in nerve sorbitol concentrations at both does of ranirestat vs placebo controls. Results were ascertained by NCS (nerve conduction study) and VPT (vibration perception threshold) which were performed at 12 weeks to assess outcome and then at 60 weeks.

The study directors concluded that @ a 20mg/day dose, ranirestat maintained the improved nerve function seen at 12 weeks through 60 weeks as measured by NCV and VPT. Sensory nerve function was maintained and motor nerve function was improved.

The authors noted their findings agreed with those reported for another ARI, zanarestat in which decreases in sorbitol concentrations led to increased density of small diameter sural nerve myelinated fibers. HOWEVER, the authors also noted that their results need to be confirmed in a placebo controlled trial of long duration, e.g. 12 months which carries more statistical weight. Nonetheless, the results confirm that the polyol pathway is a major contributor to DSP.

http://news.med.cornell.edu/wcmc/wcm...06_09_05.shtml

http://www.medscape.com/viewarticle/520964

http://www.jhasim.com/files/articlef...A_p264_269.pdf

http://forum.lowcarber.org/showthread.php?t=253227

This area has been around for ~40years now since the importance of the polyol pathway in DSP was discussed in the late '60's.

Alkymst

Well, glory be!!! I just happen to be in a diabetical protocol called THE ACCORD PROGRAM at Cornell Weill Presbyterian Hospital in NYC. And I have diabetic neuropathy.

I am printing out this information on Ranirestat and run it by the people I see when I go there.

Will advise what they say.

Melody

Melody!
I hoped you would reply because I knew you went to Cornell for your treatment but it would be presumptious of me to say so. Do post what you find out - if I can help out with anything else for you about ranirestat or ARI's in general let me know.

Ever longer pain free times to you and Alan.

alkymst

Alkymst"

You can PRESUME, all you want as it pertains to me. Are you kidding? Anytime you want me to ask Cornell anything, just pm me.

Sometimes, I ask them about stuff and if it's not in their protocol, of course, they can't help me, but they always answer all my questions.

Been going to them a few years now. Began when my sugar was 400 and my A1c was 9.0. My sugar is much more reasonable. Sometimes it's 84 and sometimes it's 124. I'm down to 30 (of the Lantus) (sometime I make the syringe go to 32), cause it's hard to judge. But my sugar is wonderful compared to when I began that. They got my weight down (actually I got my weight down) but they really inspired me.

And you should see them when I get on a scale and I lose 2 lbs. I think they have lost their minds, they are whooping and hollering and cheering. I look at them and say in a very slow voice: "are you people mad, what the hell is 2 lbs, it's like my toe?" and we all laugh. They are really a nice bunch of people. They take my blood, they check my feet, they send me to the Opthamologist (I will never forget that) because do you know how expensive it must be to go to the Opthamologist in Cornell???

Oh, the last time I went, after doing all the light shining behind my eyes, and the taking pictures, and the injecting dye in my arm, I remember asking the doctor, "if I could ever afford it, could I get Lasik surgery so I won't need glasses". and he said "no, you are not a candidate". I wish I remembered if I asked him why, but I don't!! Next time I will.

Best thing I ever did for myself was go to Cornell. And the Food Emporium is nearby, so when I have an hour before the Acess-a-ride comes, you should see what I buy in the Food Emporium. They have Emeril Salads and all this great produce. And the people outside in the fruit and vegetable stands. Fabulous.

Alan knows to expect me with big bags of produce on the day I go to NYC and to Cornell. I bring cold keepers (the things you keep in your freezer). Then I can buy their famous cajun catfish and it stays fresh all the way home.

Oh, guess what I bought today?? I use the V-slicer but lately my arthritis in my hands, well, I just can't be bothered holding the gadget and taking the zucchini and slicing and dicing. It's really hard on the hands.

So I saw the commercial on tv for the Vidalia Slicing thing.

I just came back from CVS and bought myself this gadget.

Hoo Hah!! you should have seen me chopping veggies in my kitchen.

Took me all of 1 minute to chop up 5 zucchinis, two bell peppers, 3 carrots, and an onion. I was having the time of my life. You just put the vegetable on the thing, you press down (I use my arm) and VOILA!!!! all your veggies are chopped. If I want to make veggie patties, I just use the mincing blade. It's the most amazing gadget.

So now I can stir fry anything I want and my hands won't hurt.

God bless infocommercials!!!!!

Mel

What is a veggie patty? Sounds yum.

Ah, you'd like my veggie pattie recipe would you!!!! No problem.

Take any veggies you like (me? I like zucchinis, carrots, celery, onions, a little chopped up spinach). Chop up all veggies very fine.

In a bowl, (this is zero cholesteral) so I use egg beaters. If you have no problems with cholesterol, then use an egg or two.

I do this by trial and error so I don't measure anything. I just take a whole bowl of chopped veggies, a cup or so of low-sodium breadcrums, a half cup of egg beater (or two eggs), add some garlic powder. Mix everything up so when you grab a handful, it sticks together (see the trial and error thing going on here?), you learn what works as you go.

Spray some Pam in a skillet. You can add a little extra virgin olive oil. Can't hurt!!! Then you put your hand in the mixture and you form patties.

When the skillet gets hot, you plop in the patties, watching carefully as they brown. Then slip a spatula in them and turn them around. Put the gas on low and leave them to cook for about 20 minutes. It all depends how thick you make them.

When you think they are done, you can keep flipping them to get more brown if you wish. Alan likes these nice and crispy.

I drain them on a paper towel, so there is no added oil or anything. I don't use much oil so it's no problem.

Then (and this is only on my husband's patties), I drizzle some honey.

He goes nuts!!!!!