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Robert N. Frank, MD
Wayne State University Detroit

JAMA. 1985;254(11):1452.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The finding of Eaton et al,¹ that administration of the aldose-reductase inhibitor, sorbinil, markedly improves joint mobility in the hands of diabetic patients, is of considerable interest. However, I take issue with their suggested explanation, namely, that it is due to reduction of excessive hydration of tendon collagen, produced by decreasing the local concentration of sorbitol.

Recently, we² and others³ have also reported changes in extracellular matrix with marked thickening and other morphological alterations of vascular basement membranes in galactosemic rats. These changes appeared to be identical with the abnormalities seen in diabetic patients, and they could also be prevented by sorbinil. We hesitated to explain these findings using the osmotic hypothesis that has been advanced to explain diabetic and galactosemic cataractogenesis,⁴ and that, in only slightly varied form, Eaton et al appear to be proposing to explain their results. The reason is . . . [Full Text PDF of this Article]

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