Friday, November 6, 2009

Sorbitol: cardiac toxin, causes neuropathy in diabetes

Sorbitol: cardiac toxin, diabetes exacerbater, warned by our own government the substance is not to be injected!

This is the official FDA information on sorbitol:

Not for injection.

Pediatric Use
Safety and effectiveness in pediatric patients have not been established.

The sudden injection of extra sorbitol can ruin the equilibrium of enzymes that regulate the conversion of glucose to fructose in a process associated with the onset of diabetes and its complications. Further, the polyol pathway is involved with a complex network of metabolic activities; disruption leads to a cascade of problems (citations here, here and here) such as mitochondrial failure, cell apoptosis (cell death), and DNA fragmentation. In general, sorbitol induces cell hyperosmotic stress resulting in phosphorylation (uptake of phosphorus into cell) -- an important on/off switch regulating enzymes and signaling networks. This government record prominently states under Drug Warnings that sorbitol is not to be injected.

A sugar alcohol found in various berries and fruits; in mammals, sorbitol is an intermediate in the conversion of glucose to fructose. It is found in lens deposits in diabetes mellitus. A 50% solution is used as an osmotic diuretic.

Significant cardiopulmonary,renal dysfunction, diabetes mellitus, hyponatremia, hypovolemia

Adverse Reactions (Side Effects):
CNS: seizures, vertigo
CV: angina, hypotension, congestive heart failure
EENT:Blurred vision, rhinitis, thirst
GI: Colonic necrosis, diarrhea, nausea, vomiting
GU: Acidosis, diuresis, edema, urinary retention
METAB: acidosis, hyperglycemia, hypernatremia, hyponatremia
Skin: rash, urticaria

Gastrointestinal side effects have included sudden severe abdominal bloating, abdominal cramping, vomiting, and osmotic diarrhea.

The use of sorbitol is contraindicated in patients with anuria. Sorbitol should not be used in patients with suspected or documented fructose intolerance. Sorbitol should not given by injection.

Sudden severe abdominal bloating and diarrhea have been reported in patients ingesting sorbitol.

Life threatening adverse reactions with intravenous sorbitol infusions have been reported in patients with fructose intolerance. The literature reports occasional adverse reactions for intravenous sorbitol infusions. These include disturbances such as acidosis, electrolyte loss, marked diuresis, urinary retention, edema, dryness of mouth and thirst, and dehydration; cardiovascular/pulmonary disorders such as pulmonary congestion, hypotension, tachycardia, angina-like pains, and other general reactions such as blurred vision, convulsions, nausea, vomiting, diarrhea, rhinitis, chills, vertigo, and backache. Allergic reactions reported to occur from sorbitol include urticaria. Should adverse reactions occur, discontinue the irrigant and reevaluate the clinical status of the patient.

(this article lays it flat out: sorbitol in your blood stream is vastly more dangerous than sorbitol in food!)

Sorbitol: Poison in Your Body, OK in Foods
Posted Aug 26 2008 by Dr. Mirkin

When blood sugar levels rise too high, sugar sticks to the surface membranes of cells. The sugar, glucose, is converted into another sugar, fructose, and eventually to sorbitol, which destroys the cells. This cell damage leads to heart attacks, strokes, blindness, deafness, kidney damage and the other harmful effects of diabetes. The same chemical is harmless when it is used in foods because you do not absorb it.

Studies supporting causation of sorbitol to exacerbating diabetes or causing neuropathy in diabetes patients:

Sim HJ, Jeong JS,
HPLC with pulsed amperometric detection for sorbitol as a biomarker for diabetic neuropathy.

J Chromatogr B Analyt Technol Biomed Life Sci. 2009 May 15;877(14-15):1607-11

Ido Y, Nyengaard JR, Early Neural and Vascular Dysfunction in Diabetic Rats are Largely Sequelae of Increased Sorbitol Oxidation. Antioxid Redox Signal. 2009 Jul 22.

Jakić M, Diabetic nephropathy and prevention of diabetic nephropathy caused chronic renal insufficiency, Lijec Vjesn. 2009 Jul-Aug;131(7-8):218-25.

Excerpt: Pathogenesis of diabetic nephropathy is based on hyperglycemia and distinct hemodynamic changes, glomerular hyperfiltration and high intraglomerular pressure. The important role have oxidative stress, advanced glycation end products, some cytokines, growth factors and sorbitol pathway.

LIU Tsang-Pai ; JUANG Shiow-Wen; The role of sorbitol pathway and treatment effect of aldose reductase inhibitor ONO2235 in the up-regulation of cardiac M2-muscarinic receptors in streptozotocin-induced diabetic rats; Neuroscience letters, 2005, vol. 383, no1-2, pp. 131-135 .

Emanuela Ciuchi, Patrizio Odetti; Relationship between glutathione and sorbitol concentrations in erythrocytes from diabetic patients; Metabolism, Volume 45, Issue 5, May 1996

Saraswat M, Muthenna P, Dietary sources of aldose reductase inhibitors: prospects for alleviating diabetic complications, Asia Pac J Clin Nutr. 2008;17(4):558-65.

Excerpt: The ex vivo incubation of erythrocytes in high glucose containing medium was used to underscore the significance in terms of prevention of intracellular sorbitol accumulation.

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