• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

Repurposing diabetes drugs for cognitive dysfunction

Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
My title as the implications go beyong this first paper :

Repurposing Diabetes Drugs for Brain Insulin Resistance in Alzheimer Disease

http://diabetes.diabetesjournals.org/content/63/7/2253.full

This is the full paper so it's long and a bit dense but the gist of it is that there is evidence that Alzheimer pathology may involve dysruption in brain glucose regulation and that AD may be considered a 'type 3' diabetes.

Glucose dysregulation in the brain does not necessary reflect systemic dysregulation beyond the CNS.

Current diabetes meds, particularly those that easily cross the BBB may be repurposed as a treatment (preventative, to slow disease progress and potentially to improve cognition) for AD and possibly other neurodegenerative/neuroinflammatory conditions.

Drugs/biologicals under consideration include intranasal insulin (a current trial is assessing its effects on cognitive impairment in GWS) and leptin (while not an analogue of insulin leptin impacts the same pathways).

On a slightly different but related note, this paper reviews fatigue (physical, reduced activity plus cognitive deficits) in type I and type II diabetes and v controls.

Fatigue and cognitive symptoms in patients with diabetes: Relationship with disease phenotype and
insulin treatment

http://www.psyneuen-journal.com/article/S0306-4530(12)00053-4/fulltext?mobileUi=0

While fatigue and cognitive problems have been variably reported in both types of diabetes, in this study increased physical fatigue and reduced activity compared to controls was found only in type II diabetics while cognitive impairments (reduced processing speed, impaired spatial planning) were found only in insulin treated type II diabetics which was unrelated to diabetes complications such as peripheral neuropathy or to blood glucose control suggesting alternative mechanisms such as adipose tissue induced inflammatory cytokines.

In short impaired insulin metabolism/insulin resistance may be implicated in fatigue, cognitive impairment and cognitive decline in several conditions.

 

Hip

Senior Member
Messages
17,820
intranasal insulin (a current trial is assessing its effects on cognitive impairment in GWS)

I'd read about the use of intranasal insulin in the context of Alzheimer's, but that researchers are looking to see if it helps Gulf War Syndrome/Illness is news to me. I presume there must have been some initial anecdotal evidence that intranasal insulin helps GWS, which then spurred on the clinical trial.
 

Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
I'd read about the use of intranasal insulin in the context of Alzheimer's, but that researchers are looking to see if it helps Gulf War Syndrome/Illness is news to me. I presume there must have been some initial anecdotal evidence that intranasal insulin helps GWS, which then spurred on the clinical trial.

Here's the clinical trial info (due for completion at the end of 2016) :

https://clinicaltrials.gov/ct2/show/NCT01802944

The rationale seems to be based on evidence of effectiveness on cognitve dysfunction in other conditions and a working hypothesis that GWS pathophysiology involves 'neuroinflammation' to some extent. I haven't found any evidence that there are any anecdotal reports.