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Aldose Reductase Inhibitors Aldose reductase inhibitors (ARI) work by blocking the enzyme aldose reductase in the polyol pathway, which under hyperglycemic conditions converts excess glucose into sorbitol, a sugar alcohol that accumulates in nerves and causes osmotic stress, oxidative damage and impaired nerve function [116]

Vitamin B12 is the most chemically complex of all the vitamins, and cyanocobalamin and hydroxycobalamin are synthetically derived therapeutic forms of vitamin B12.6 Hydroxycobalamin protein binding capacity is greater than that of cyanocobalamin and both of them may cause allergic reactions.6 Vitamin B12 may lead to allergic reactions because of its cobalt molecule, molecular complexity or high molecular mass

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