I recently heard about a nose spray containing insulin as a possible future treatment for Alzheimer's disease. How does it work and is there an Alzheimer's nose spray available?
Answer From Jonathan Graff-Radford, M.D.
Insulin — a hormone that helps regulate your blood sugar — appears to play a role in normal memory processes. Insulin irregularities may contribute to cognitive and brain changes associated with Alzheimer's disease.
In the past several years, researchers have been investigating the use of insulin to treat Alzheimer's disease. One of the challenges is how to provide insulin in such a way that it improves brain function without significantly disrupting your blood sugar levels. If your blood sugar drops too low, for example, it can create complications, such as confusion, heart palpitations, anxiety and visual disturbances.
Early research suggested that when taken as a nose spray, insulin could possibly improve memory and help preserve cognitive function in people with early Alzheimer's disease or mild cognitive impairment.
However, study results have been mixed. Some recent trials showed negative results. A large, well-designed study investigating the impact of nasal insulin on people with mild cognitive impairment or mild Alzheimer's disease found no benefits from the drug. But others found that nasal insulin may improve some aspects of memory and daily activity.
While optimism for insulin has been dampened, researchers are still trying to understand if and how insulin might be used to manage Alzheimer's disease and other dementias.
June 29, 2021
Jonathan Graff-Radford, M.D.
See more Expert Answers
- Keene CD, et al. Epidemiology, pathology, and pathogenesis of Alzheimer disease. https://www.uptodate.com/contents/search. Accessed May 17, 2021.
- Avgerinos KI, et al. Intranasal insulin in Alzheimer's dementia or mild cognitive impairment. A systematic review. Journal of Neurology. 2018; doi:10.1007/s00415-018-8768-0.
- Chapman CD, et al. Intranasal insulin in Alzheimer's disease: Food for thought. Neuropharmacology. 2018; doi:10.1016/j.neuropharm.2017.11.037.
- Hallschmid M. Intranasal insulin for Alzheimer's disease. CNS Drugs. 2021; doi:10.1007/s40263-020-00781-x.
- Graff-Radford J (expert opinion). Mayo Clinic. May 20, 2021.