Status:

COMPLETED

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

Lead Sponsor:

Beth Israel Deaconess Medical Center

Collaborating Sponsors:

Boston University

Joslin Diabetes Center

Conditions:

Type 2 Diabetes Mellitus

Eligibility:

All Genders

50-85 years

Phase:

PHASE2

Brief Summary

Our goal is to determine the acute effects of intranasal insulin on regional perfusion and cognition of older adults. We propose a pilot study to examine the effect of a single dose of intranasal insu...

Detailed Description

Type 2 diabetes mellitus (T2DM) is a major risk factor for vascular dementia. DM alters insulin transport across blood-brain barrier affecting perfusion and neuronal function. Intranasal administratio...

Eligibility Criteria

Inclusion

  • Diabetes group:
  • 30 men and women aged \>50 years old diagnosed with T2DM and treated \> 5 years with oral agents
  • Diabetes severity will be assessed from diabetes duration, hemoglobin A1C, and fasting glucose levels.
  • Control group:
  • 30 healthy men and women aged \>50 years selected to have the same age and sex distributions as the diabetic subjects
  • Normotensive, not treated for any systemic disease, and have normal fasting blood glucose.

Exclusion

  • Type 1 Diabetes Mellitus
  • History of severe hypoglycemia or hypoglycemic episode during home baseline monitoring
  • Positive stress test for CAD or other ischemic conditions
  • Carotid stenosis \> 50% by medical history
  • History of a clinically documented stroke
  • Treatment with any medications administered intranasally including intranasal steroids
  • Any previous adverse or allergic reactions to insulin
  • Acute or unstable medical condition including Myocardial infarction or major illness and surgery within six months
  • Liver or renal failure or transplant
  • Uncontrolled hypertension (systolic BP \>180 and/or diastolic BP \>100 mm Hg or subjects taking more than 3 antihypertensive medications)
  • Seizure disorders
  • Malignant tumors
  • Clinical dementia (by history) or inability to follow details of the protocol(MMSE (Mini Mental Status Exam) score (≥3 points below the Comparative Normal Value for the subject's age group and education level, or ≤ 24)
  • Current recreational drug or alcohol abuse
  • Morbid obesity (BMI \>40)
  • Inability to obtain permission for participation from the primary care physician
  • Transcranial Doppler (TCD) exclusion criterion - poor insonation window and TCD signal
  • MR exclusion criteria - any metal or bioimplants not compatible with 3 Tesla MRI and claustrophobia
  • Clinically significant and movement limiting hip, knee and/or back disorders or injury, and rheumatoid arthritis

Key Trial Info

Start Date :

May 1 2010

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

April 1 2013

Estimated Enrollment :

30 Patients enrolled

Trial Details

Trial ID

NCT01206322

Start Date

May 1 2010

End Date

April 1 2013

Last Update

June 26 2019

Active Locations (1)

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1

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States, 02215