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15,226,227 Recent therapeutic approaches focus on aldose reductase inhibitors (ARIs), such as epalrestat and ranirestat, which have shown promise in reducing sorbitol accumulation and ameliorating neuropathic symptoms in clinical trials

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Impaired activity of methionine synthase results in elevated blood concentrations of homocysteine, while impaired activity of L-methylmalonyl-CoA mutase results in increased concentrations of a metabolite of methylmalonyl-CoA called methylmalonic acid (MMA) in blood and urine