Raising insulin in brain improves cognitive scores

[mike]

For patients with MCI, raising insulin in the brain helps raise cognitive scores and improves AB and Tau

https://www.medpagetoday.com/meetingcov ... 669819d41r

"This is a large effect in the device 1 group, particularly as it is on top of background treatment," Craft said. "At 18 months, the results show a prolonged, statistically significant benefit for the insulin-treated group who used device 1 that strengthens over time, with a pattern consistent with a disease-modifying effect."

Cerebrospinal fluid analysis showed the Aβ42/40 ratio (P=0.01) and Aβ42/tau ratio (P=0.03) also improved for people treated with device 1. (Aβ42 and Aβ40 are the 42- and 40-amino acid forms of the amyloid-beta protein.)

"It's encouraging to see that if you do get insulin to the brain, you see changes in biomarkers," said Laurie Ryan, PhD, Chief of the Dementias of Aging Branch of the National Institute on Aging, which funded the study. "That's important, but it needs to be tested," she told MedPage Today. "It's got to go to a larger phase III study."

[circular]

Only have time to read your quote, but that is interesting. Isn’t there insulin resistance in the brain with MCI?

[TheresaB]

Isn’t there insulin resistance in the brain with MCI?

You're absolutely correct.

This is not the first time I’ve heard of a study that introduced intranasal insulin, which bypasses the blood brain barrier, and achieving improvement in cognition.

from 2004
Intranasal insulin improves memory in humans

from 2008
Intranasal delivery bypasses the blood-brain barrier to target therapeutic agents to the central nervous system and treat neurodegenerative disease

and from 2013
Intranasal insulin as a treatment for Alzheimer's disease: a review of basic research and clinical evidence

maybe others

The fear is that, while this does produce improvement, you’re actually worsening the insulin resistance in the brain, causing more problems in the long run than you’re solving.

Just like giving insulin to a Type 2 diabetic, that may lower blood glucose levels, but you’re adding insulin to an already insulin resistant person, you’re not getting to the underlying problem, in fact you're worsening the underlying problem.

Similarly with exogenous ketones, it can help boost cognition by providing fuel to the brain, but if you don’t address the underlying reason for the impairment of brain fuel uptake, it’s not a solution, it’s a band-aid.

[Julie G]

BINGO. Preach, Theresa!

[circular]

The fear is that, while this does produce improvement, you’re actually worsening the insulin resistance in the brain, causing more problems in the long run than you’re solving.

Just like giving insulin to a Type 2 diabetic, that may lower blood glucose levels, but you’re adding insulin to an already insulin resistant person, you’re not getting to the underlying problem, in fact you're worsening the underlying problem.

Those were my thoughts too, although I wonder if maybe in some older people with MCI they can benefit for their remaining years while not having enough time left for the downside. In fact, if it improves AB and tau, maybe it can be used short term and still confer benefit from the lower AB and tau levels going forward.

It wouldn't be my choice for brain health now, but I'm just thinking it may have application for some patients later in years who are averse to going keto and making other radical lifestyle changes. Often once a senior has MCI it's extremely hard to institute a protocol along the lines of what many of us do here.

[emmabarton]

It's great this research exists-- I'd love to see large scale randomized controlled trials on how specific lifestyle/nutrition interventions alter insulin resistance for MCI.

[DebS]

It's great this research exists-- I'd love to see large scale randomized controlled trials on how specific lifestyle/nutrition interventions alter insulin resistance for MCI.

Welcome emmabarton! One source for research is Google Scholar. You can enter your search request in everyday language and find studies that pertain to your search subject. On the left side of the screen, you can limit the results to more recent studies. One other tip would be when you do a general Google search to add "site:.gov" to the end of your search terms to give you more study results.

If you haven't found it yet, our primer, written by Dr. Stavia, offers a great deal of information as well as prioritized prevention strategies. This guide will help you with tips like quoting someone to whom you are responding so they see your response.

Feel free to ask any questions you have. I look forward to your future posts!

[NF52]

It's great this research exists-- I'd love to see large scale randomized controlled trials on how specific lifestyle/nutrition interventions alter insulin resistance for MCI.

Hi Emma!
The good news is that some studies are looking at insulin and MCI. Clincial Trials. gov: Studies with MCI and insulin currently active or recruiting

The National Institute of Health hosts a searchable website of clinical trials. https://clinicaltrials.gov/ct2/home

They range from small academic or research center studies to multi-center and sometimes multi-country large-scale randomized controlled trials (abbreviated in articles sometimes as RCTs). The database is searchable using the Advanced Search feature by topics, extra terms (like "insulin"), age and gender, whether trials are recruiting, active, completed, etc. and by location--right down studies within 100 miles of a desired location.) The results above came from using the term "MCI" and the extra term "insulin", and checking "recruiting' "active, not recruiting", "not yet recruiting" and "enrolling by invitation"

They also offer a nice description of how clinical trials work and what questions to ask here: Learn About Clinical Trials