Polyol pathway

The pathway is implicated in diabetic complications, especially in microvascular damage to the retina,[2] kidney,[3] and nerves.

Hexokinase can return the molecule to the glycolysis pathway by phosphorylating fructose to form fructose-6-phosphate.

However, in uncontrolled diabetics that have high blood glucose - more than the glycolysis pathway can handle - the reactions mass balance ultimately favors the production of sorbitol.

[6] Activation of the polyol pathway results in a decrease of reduced NADPH and oxidized NAD+; these are necessary co-factors in redox reactions throughout the body, and under normal conditions they are not interchangeable.

AGEs are thought to cause disease in the human body, one effect of which is mediated by RAGE (receptor for advanced glycation end-products) and the ensuing inflammatory responses induced.

A glutathione deficiency, congenital or acquired, can lead to hemolysis caused by oxidative stress.