Insulin Mist may Help the Brain

Not regular, liquid insulin. Not insulin injections a person might take for Diabetes.

But for years, Suzanne Craft has known that brain cells need insulin, Gina Kolata reported in the New York Times.

Craft also recognized that conditions in which the body makes too little insulin or is resistant to the effects of insulin such as diabetes, prediabetes, even untreated high-blood pressure — are associated with an increased risk of Alzheimer’s. Craft is professor of psychiatry at the University of Washington in Seattle and director of the memory disorders clinic at the Veterans Affairs Puget Sound Health Care System.

Craft also noted, beta amyloid, a toxic protein that accumulates in the brain of Alzheimer’s patients seems to tie up insulin already in the brain.

Knowing all this Dr. Craft reasoned, perhaps if more insulin could be put into the brains of people with the degenerative brain disease, their memories and ability to function might improve. The problem was–how to get insulin into the brain without also flooding it into the body.

The answer was a special device which allows a fine mist of insulin to be sprayed into the brain without additional insulin entering the rest of the body. This device is designed and manufactured by Kurve Technology. The spray is delivered deep into the nose. From there the hormone travels along the path of nerves into the brain.

With this device, a small pilot study found preliminary evidence that squirting insulin deep into the nose where it travels to the brain might hold early Alzheimer’s disease at bay, researchers said on Monday.

At the current time there is no way to prevent or delay the progress of Alzheimer’s. And though this study was only a small one, the reults were met enthusiastically but with caution. Dr. Jason Karlawish, an Alzheimer’s researcher and ethicist at the University of Pennsylvania, adds, “it is a provocative study.”

“It’s important readers realize this is a pilot trial,” said Dr. P. Murali Doraiswamy, an Alzheimer’s researcher at Duke University who was not part of the study. “It’s not ready for prime time.”

Although Dr. Craft is ready for a more extensive study with the insulin mist, she cautions Alzheimer’s patients not to rush out and try to take insulin. It is too soon to say if the treatment is even safe, she said. And patients would need a special device to get it deep into the nose. Kurve’s device is not yet on the market.

In this first, small pilot trial group of 104 people, it was a four-month study. The group randomly assigned to receive intranasal insulin twice a day either improved slightly or remained the same in tests of memory and assessments of their ability to handle day-to-day activities. The lower dose seemed more effective than the higher one. Those who received placebos got worse.

Some of the participants of this trial also had scans to assess their brains’ use of glucose. One notable aspect of  Alzheimer’s disease is reduced metabolism in the brain. Brain scans show this as less use of glucose, the fuel for brain cells. In this trial, brain scans showed those getting insulin used more glucose in their brains; those taking placebos used less.

With the optimistic results from this small trial, I’m waiting for the larger study with anticipation! A larger study may show these same results and more, offering more hope for a delay in symptoms if not a cure for Alzheimer’s.

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