Enhancement of Vasoreactivity and Cognition by Intranasal Insulin in Type 2 Diabetes

Autor: Vera Novak, Medha Munshi, Andrew M. Galica, Paula K. Roberson, Bradley Manor, Ying Hao, William P. Milberg, Amir M. Abduljalil, Suzanne Craft, Peter Novak
Rok vydání: 2014
Předmět:
Male
Emerging Technologies and Therapeutics
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Type 2 diabetes
Neuropsychological Tests
Insular cortex
03 medical and health sciences
Cognition
0302 clinical medicine
Double-Blind Method
Memory
medicine.artery
Diabetes mellitus
Internal Medicine
medicine
Humans
Hypoglycemic Agents
Insulin
Effects of sleep deprivation on cognitive performance
Cerebral perfusion pressure
Administration
Intranasal
030304 developmental biology
Advanced and Specialized Nursing
0303 health sciences
business.industry
Brain
Middle Aged
medicine.disease
3. Good health
Vasodilation
Diabetes Mellitus
Type 2
Cerebrovascular Circulation
Anesthesia
Middle cerebral artery
Female
Nasal administration
business
Magnetic Resonance Angiography
030217 neurology & neurosurgery
Zdroj: Diabetes Care
ISSN: 1935-5548
0149-5992
DOI: 10.2337/dc13-1672
Popis: OBJECTIVE To determine acute effects of intranasal insulin on regional cerebral perfusion and cognition in older adults with type 2 diabetes mellitus (DM). RESEARCH DESIGN AND METHODS This was a proof-of-concept, randomized, double-blind, placebo-controlled intervention evaluating the effects of a single 40-IU dose of insulin or saline on vasoreactivity and cognition in 15 DM and 14 control subjects. Measurements included regional perfusion, vasodilatation to hypercapnia with 3-Tesla MRI, and neuropsychological evaluation. RESULTS Intranasal insulin administration was well tolerated and did not affect systemic glucose levels. No serious adverse events were reported. Across all subjects, intranasal insulin improved visuospatial memory (P ≤ 0.05). In the DM group, an increase of perfusion after insulin administration was greater in the insular cortex compared with the control group (P = 0.0003). Cognitive performance after insulin administration was related to regional vasoreactivity. Improvements of visuospatial memory after insulin administration in the DM group (R2adjusted = 0.44, P = 0.0098) and in the verbal fluency test in the control group (R2adjusted = 0.64, P = 0.0087) were correlated with vasodilatation in the middle cerebral artery territory. CONCLUSIONS Intranasal insulin administration appears safe, does not affect systemic glucose control, and may provide acute improvements of cognitive function in patients with type 2 DM, potentially through vasoreactivity mechanisms. Intranasal insulin-induced changes in cognitive function may be related to vasodilatation in the anterior brain regions, such as insular cortex that regulates attention-related task performance. Larger studies are warranted to identify long-term effects and predictors of positive cognitive response to intranasal insulin therapy.
Databáze: OpenAIRE
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