Diabetes, Vol 38, Issue 2 257-261, Copyright © 1989 by American Diabetes Association
Ascorbic acid metabolism and polyol pathway in diabetes
DK Yue, S McLennan, E Fisher, S Heffernan, C Capogreco, GR Ross and JR Turtle
Department of Medicine, University of Sydney, New South Wales, Australia.
It has been reported previously that the plasma concentration of ascorbic
acid (AA) is reduced in streptozocin-induced diabetic rats and can be
normalized by treatment with the aldose reductase inhibitor tolrestat. This
study was designed to investigate further the relationship between the
polyol pathway and AA metabolism in diabetic rats. Disturbance of AA
metabolism was demonstrable after 1 wk of diabetes. Dietary myo-inositol
supplementation was effective in normalizing plasma AA levels, as was
treatment with tolrestat. In untreated diabetes, despite low plasma AA
concentration, there was increased urinary excretion of AA that was
reversed by treatment with either tolrestat or myo-inositol. In contrast,
AA supplementation normalized plasma AA concentrations while further
increasing urinary AA excretion. The abnormality of AA metabolism was less
severe in galactose-fed rats, which had normal plasma AA levels and only
minor increases in urinary AA excretion. These studies demonstrated a
disturbance in the regulation of plasma and urinary AA concentration in
experimental diabetes and confirmed the relationship of AA with the polyol
pathway. Because AA has many important biological functions, abnormalities
of AA metabolism could be important in the pathogenesis of some diabetic
complications. The interaction of the polyol and AA pathways suggests that
this could be another site of action for aldose reductase inhibitors.