MemAID: Memory advancement with intranasal insulin vs. placebo in type 2 diabetes and control participants: a randomized clinical trial

Autor: Vera Novak, Christos S. Mantzoros, Peter Novak, Regina McGlinchey, Weiying Dai, Vasileios Lioutas, Stephanie Buss, Catherine B. Fortier, Faizan Khan, Laura Aponte Becerra, Long H. Ngo
Rok vydání: 2022
Předmět:
Zdroj: Journal of Neurology. 269:4817-4835
ISSN: 1432-1459
0340-5354
DOI: 10.1007/s00415-022-11119-6
Popis: This study aimed at assessing the long-term effects of intranasal insulin (INI) on cognition and gait in older people with and without type 2 diabetes mellitus (T2DM).Phase 2 randomized, double-blinded trial consisted of 24 week treatment with 40 IU of INI (NovolinDM-INI had faster NW (~ 7 cm/s; p = 0.025) and DTW on-treatment (p = 0.007; p = 0.812 adjusted for baseline difference) than DM-Placebo. Control-INI had better executive functioning on-treatment (p = 0.008) and post-treatment (p = 0.007) and verbal memory post-treatment (p = 0.004) than Control-Placebo. DM-INI increased cerebral blood flow in medio-prefrontal cortex (p 0.001) on MRI. Better vasoreactivity was associated with faster DTW (p 0.008). In DM-INI, plasma insulin (p = 0.006) and HOMA-IR (p 0.013) decreased post-treatment. Overall INI effect demonstrated faster walking (p = 0.002) and better executive function (p = 0.002) and verbal memory (p = 0.02) (combined DM-INI and Control-INI cohort, hemoglobin A1c-adjusted). INI was not associated with serious adverse events, hypoglycemic episodes, or weight gain.There is evidence for positive INI effects on cognition and gait. INI-treated T2DM participants walked faster, showed increased cerebral blood flow and decreased plasma insulin, while controls improved executive functioning and verbal memory. The MemAID trial provides proof-of-concept for preliminary safety and efficacy and supports future evaluation of INI role to treat T2DM and age-related functional decline.
Databáze: OpenAIRE
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