Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysis

ABSTRACT. Alzheimer disease (AD) is a neurodegenerative disorder. Evidence suggests that AD shares pathophysiological similarities with type 2 diabetes. Intranasal insulin (INI) has emerged as a potential therapeutic approach for AD by directly targeting the brain and modulating insulin signaling pa...

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Main Authors: Luís Jesuíno de Oliveira Andrade, Gabriela Matos, Luís Matos de Oliveira
Format: Article
Language:English
Published: Associação Neurologia Cognitiva e do Comportamento 2025-04-01
Series:Dementia & Neuropsychologia
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642025000100304&lng=en&tlng=en
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author Luís Jesuíno de Oliveira Andrade
Gabriela Matos
Luís Matos de Oliveira
author_facet Luís Jesuíno de Oliveira Andrade
Gabriela Matos
Luís Matos de Oliveira
author_sort Luís Jesuíno de Oliveira Andrade
collection DOAJ
description ABSTRACT. Alzheimer disease (AD) is a neurodegenerative disorder. Evidence suggests that AD shares pathophysiological similarities with type 2 diabetes. Intranasal insulin (INI) has emerged as a potential therapeutic approach for AD by directly targeting the brain and modulating insulin signaling pathways. Objective: To evaluate the efficacy and safety of INI therapy for AD through a systematic review and meta-analysis of randomized controlled trials. Methods: A search of electronic databases, including PubMed, Web of Science, Scopus, and Embase, was conducted to identify relevant studies published up to June 2024. Inclusion criteria encompassed peer-reviewed original research articles focused on humans, investigating the therapeutic effects of INI administration on cognitive impairment associated with AD, and reporting quantitative data on cognitive outcomes, biomarkers, or pathological markers relevant to AD. A meta-analysis was conducted to quantitatively synthesize the effects of INI on cognitive outcomes. Results: A total of 647 articles were identified, and eight studies met the inclusion criteria. The overall odds ratio was 3.75 (95%CI 1.49–9.40). The test for overall effect showed a statistically significant difference (p<0.05). However, the I2 value indicated a high level of heterogeneity (85.5%), suggesting significant variability among the studies. Conclusion: While the current data is not yet conclusive enough to definitively establish INI as a standard treatment for AD, the evidence supporting its safety, efficacy, and reduced risk of systemic side effects suggests potential cognitive benefits for improving global cognition in patients with AD.
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spelling doaj-art-8b08fcfba8484b17a45e06bf7ae54b672025-08-20T02:26:02ZengAssociação Neurologia Cognitiva e do ComportamentoDementia & Neuropsychologia1980-57642025-04-011910.1590/1980-5764-dn-2024-0191Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysisLuís Jesuíno de Oliveira Andradehttps://orcid.org/0000-0002-7714-0330Gabriela Matoshttps://orcid.org/0000-0002-8042-0261Luís Matos de Oliveirahttps://orcid.org/0000-0003-4854-6910ABSTRACT. Alzheimer disease (AD) is a neurodegenerative disorder. Evidence suggests that AD shares pathophysiological similarities with type 2 diabetes. Intranasal insulin (INI) has emerged as a potential therapeutic approach for AD by directly targeting the brain and modulating insulin signaling pathways. Objective: To evaluate the efficacy and safety of INI therapy for AD through a systematic review and meta-analysis of randomized controlled trials. Methods: A search of electronic databases, including PubMed, Web of Science, Scopus, and Embase, was conducted to identify relevant studies published up to June 2024. Inclusion criteria encompassed peer-reviewed original research articles focused on humans, investigating the therapeutic effects of INI administration on cognitive impairment associated with AD, and reporting quantitative data on cognitive outcomes, biomarkers, or pathological markers relevant to AD. A meta-analysis was conducted to quantitatively synthesize the effects of INI on cognitive outcomes. Results: A total of 647 articles were identified, and eight studies met the inclusion criteria. The overall odds ratio was 3.75 (95%CI 1.49–9.40). The test for overall effect showed a statistically significant difference (p<0.05). However, the I2 value indicated a high level of heterogeneity (85.5%), suggesting significant variability among the studies. Conclusion: While the current data is not yet conclusive enough to definitively establish INI as a standard treatment for AD, the evidence supporting its safety, efficacy, and reduced risk of systemic side effects suggests potential cognitive benefits for improving global cognition in patients with AD.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642025000100304&lng=en&tlng=enAlzheimer DiseaseInsulinAdministration IntranasalSystematic ReviewMeta-Analysis
spellingShingle Luís Jesuíno de Oliveira Andrade
Gabriela Matos
Luís Matos de Oliveira
Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysis
Dementia & Neuropsychologia
Alzheimer Disease
Insulin
Administration Intranasal
Systematic Review
Meta-Analysis
title Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysis
title_full Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysis
title_fullStr Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysis
title_full_unstemmed Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysis
title_short Intranasal insulin in Alzheimer disease (diabetes in situ?): a systematic review and meta-analysis
title_sort intranasal insulin in alzheimer disease diabetes in situ a systematic review and meta analysis
topic Alzheimer Disease
Insulin
Administration Intranasal
Systematic Review
Meta-Analysis
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642025000100304&lng=en&tlng=en
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