AKR1B1 and diabetic neuropathy: Epalrestat is a novel aldose reductase inhibitor which has been proven to have beneficial effects in diabetic neuropathy in many controlled clinical trials.(3–7) It has been suggested that accumulation of sorbitol in certain cells occurring only in conditions of hyperglycemia and resulting in a hyperosmotic effect, may be involved in the pathogenesis of some diabetic complications.