Zenarestat is used in the management of diabetic complications, particularly those affecting the nerves. It functions by inhibiting the aldose reductase enzyme, which plays a key role in the accumulation of sorbitol in tissues under high glucose conditions. By reducing sorbitol buildup, Zenarestat helps prevent or slow the progression of diabetic neuropathy, a common and painful condition characterized by nerve damage in people with diabetes. It has also been investigated for its potential to improve nerve conduction velocity and reduce symptoms such as numbness, tingling, and pain in the extremities. Additionally, Zenarestat may offer protective effects against other diabetes-related complications, including retinopathy and nephropathy, due to its action on the polyol pathway.