In the polyol pathway glucose is reduced by aldose reductase to sorbitol. Sorbitol dehydrogenase can then oxidize sorbitol to fructose.

Aldose reductase has a wide specificity

Aldose reductase has a high Km for both Glucose and NADPH
h4. Flow trough this pathway lead to low NADPH/NADP and high NADH/NAD ratio