Sorbitol

Sorbitol, also known as D-glucitol, is a six-carbon sugar alcohol and a key intermediate in the polyol pathway of glucose metabolism [3, 14]. It is synthesized from glucose through reduction by the enzyme aldose reductase and is subsequently oxidized to fructose by sorbitol dehydrogenase [15]. Sorbitol plays a significant role in human pathology, particularly in the context of diabetes mellitus; chronic hyperglycemia leads to excessive sorbitol accumulation in tissues like the retina, lens, and peripheral nerves, causing osmotic stress and oxidative damage that result in retinopathy, cataracts, and neuropathy [13, 15]. Therapeutically, sorbitol is employed as an osmotic laxative to treat constipation and as an irrigating solution for urologic and surgical procedures [1, 6]. It is also used as a pharmaceutical excipient and sweetener in various sugar-free medications and food products [11]. While sorbitol itself is a metabolite and drug, it is not considered a therapeutic target in the traditional sense of a receptor or enzyme; instead, the enzymes of the polyol pathway are the primary targets for pharmacological intervention aimed at modulating sorbitol levels [8, 18]. Safety concerns include severe gastrointestinal side effects and potential intestinal necrosis when administered concurrently with sodium polystyrene sulfonate [11].

Other names

D-GlucitolGlucitolSorbogemE420SorboPolyol

Acts primarily as an osmotic agent by creating a hyperosmotic gradient that draws water into the intestinal lumen or extracellular space; as a metabolic intermediate, it is modulated by aldose reductase inhibitors (e.g., epalrestat) which target the enzymatic synthesis of sorbitol to prevent its toxic accumulation in diabetic tissues [1, 6, 15, 18].