Page 10 - JCTR-9-4

226 AboEl-Azm et al. | Journal of Clinical and Translational Research 2023; 9(4): 222-235
Table 1. (Continued)
Study ID Design Country Duration Patient’s eligibility Type of insulin Outcomes measured Main finding
(months)
Rosenbloom Randomized, United States 6 • Mild-moderate AD - Rapid-acting insulin • Peripheral glucose levels Intranasal
et al. [16] cross-over • Who are >65 years • Verbal memory, safety, and insulin does not
old and 85 years old. efficacy improve MCI
• The Clinical Dementia • Serum insulin levels acutely and AD
Rating (CDR) for
each individual ranged
from 1 to 2
• Mini-Mental
State Examination
(MMSE) scores
ranged from 18 to 26
Rosenbloom RCT United States 6 • Patients with mild NR Primary: Intranasal
et al. [12] cognitive impairment • ADAS-Cog insulin does not
or AD • CDR-SB improve MCI
• Montreal Cognitive Secondary: and AD
Assessment (MoCA) • (COWAT)
scores of 18–27 • (WMS)-IV
• Blood glucose and insulin level
• Adverse effects (AEs) and severe
adverse effects (SAEs)
Mustapic RCT United States 4 • Patients aged 55 or NR • ADAS-Cog Intranasal
et al. [13] greater • Mini-Mental State Examination insulin improves
• Patients with mild • AD Assessment Scale for cognition MCI and AD
cognitive impairment and insulin signaling mediators
or AD as biomarkers, especially EV
• Who is on stable biomarkers of insulin resistance as
doses of memantine (pS312-IRS-1 and pY-IRS-1)
(Namenda) or
cholinesterase inhibit
Kellar RCT United States 18 • Adults between the - Humulin-R U100 • CSF macrophage-derived chemokine Intranasal
et al. [20] ages of 55 and 85 • CSF interferon-γ, CSF immune/ insulin improves
• Patients with mild inflammatory/vascular markers MCI and AD
cognitive impairment • Changes in cognition, brain volume,
or AD and amyloid and tau concentrations
• MMSE scores of 20 • CSF markers of inflammation,
or higher immune function, and vascular
• Global clinical integrity and assessed their
dementia ratings of relationship with changes in
0.5 or 1.0 cognition, brain volume, and CSF
• Logical memory- amyloid and tau concentrations,
delayed scores falling reduced interleukin-6, cerebral
within a predetermined spinal fluid (CSF) biomarker profiles
education-adjusted and slower symptom progression
range
Reger RCT United States NR • Patients with mild - Novolin R, Novo • Verbal memory Intranasal
et al. [18] cognitive impairment Nordisk, Princeton, NJ, • Verbal Memory insulin improves
or AD USA • Plasma β-Amyloid MCI and AD
• Plasma insulin and glucose levels
Reger RCT United States NR • Patients with mild - Novolin R, Novo Primary: Intranasal
et al. [17] cognitive impairment Nordisk • Intended to be verbal memory insulin improves
or AD after a delay MCI and AD
• Attention
• Caregiver assessments of
functional state
Secondary:
• Plasma levels of insulin, glucose,
beta-amyloid, and cortisol
(Cont’d...)
DOI: http://dx.doi.org/10.18053/jctres.09.202304.23-00013