Trial Outcomes & Findings for Enhancement of Cerebral Vasoreactivity and Cognition by Intranasal Insulin in Type 2 Diabetes (NCT NCT01206322)

NCT ID: NCT01206322

Last Updated: 2019-06-26

Results Overview

To determine the acute effects of a single 40-IU dose of intranasal insulin vs. placebo on cognition and regional perfusion and vasoreactivity to CO2 challenge measured by 3-D continuous arterial spin labeling (CASL) MRI at 3 Tesla in the control and diabetic groups. Cognitive outcome: Brief Visuospatial Spatial Memory test -Total Recall (unit T Score). Perfusion outcome: Regional vasoreactivity (ml/100g/min/mmHg). Each participant received a single dose of intranasal insulin (INI) or placebo on day 2 and a single dose dose of insulin or placebo on day 3 in a random order. Acute effects on baseline perfusion, regional vasoreactivity and cognition were determined within 2 hours after administration of insulin or placebo.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

30 participants

Primary outcome timeframe

Acute changes within 2 hours

Results posted on

2019-06-26

Participant Flow

Thirty consented subjects, 15 type 2 diabetic and 14 controls completed the protocol. One control was excluded after starting the study. Screened participants that did not start study: 27 were excluded after screening visit, 7 withdrew consent. Enrollment Table list the characteristics of 29 participants who completed the protocol.

Participant milestones

Participant milestones
Measure
Diabetes Group: Placebo First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Diabetes Group: Insulin First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Control Group: Placebo First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Control Group: Insulin First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Overall Study
STARTED
4
11
9
6
Overall Study
COMPLETED
4
11
9
5
Overall Study
NOT COMPLETED
0
0
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Diabetes Group: Placebo First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Diabetes Group: Insulin First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Control Group: Placebo First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Control Group: Insulin First
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo
Overall Study
Adverse Event
0
0
0
1

Baseline Characteristics

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

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Healthy
n=14 Participants
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo ( sterilesaline) in type 2 diabetes and the non-diabetic control group.Each participant received a single dose of insulin and a single dose of placebo on 2 consequent days in random order.
Diabetics
n=15 Participants
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo ( sterilesaline) in type 2 diabetes and the non-diabetic control group.Each participant received a single dose of insulin and a single dose of placebo on 2 consequent days in random order.
Total
n=29 Participants
Total of all reporting groups
Age, Continuous
60.1 years
STANDARD_DEVIATION 9.9 • n=5 Participants
62.0 years
STANDARD_DEVIATION 7.9 • n=7 Participants
61.1 years
STANDARD_DEVIATION 8.81 • n=5 Participants
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
9 Participants
n=5 Participants
12 Participants
n=7 Participants
21 Participants
n=5 Participants
Age, Categorical
>=65 years
5 Participants
n=5 Participants
3 Participants
n=7 Participants
8 Participants
n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
7 Participants
n=7 Participants
17 Participants
n=5 Participants
Sex: Female, Male
Male
4 Participants
n=5 Participants
8 Participants
n=7 Participants
12 Participants
n=5 Participants
Region of Enrollment
United States
14 participants
n=5 Participants
15 participants
n=7 Participants
29 participants
n=5 Participants

PRIMARY outcome

Timeframe: Acute changes within 2 hours

To determine the acute effects of a single 40-IU dose of intranasal insulin vs. placebo on cognition and regional perfusion and vasoreactivity to CO2 challenge measured by 3-D continuous arterial spin labeling (CASL) MRI at 3 Tesla in the control and diabetic groups. Cognitive outcome: Brief Visuospatial Spatial Memory test -Total Recall (unit T Score). Perfusion outcome: Regional vasoreactivity (ml/100g/min/mmHg). Each participant received a single dose of intranasal insulin (INI) or placebo on day 2 and a single dose dose of insulin or placebo on day 3 in a random order. Acute effects on baseline perfusion, regional vasoreactivity and cognition were determined within 2 hours after administration of insulin or placebo.

Outcome measures

Outcome measures
Measure
Diabetes Group: Placebo
n=15 Participants
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group on cognitive function (Brief Visuospatial Memory test-Revised (BVMT-R)).
Diabetes Group: Insulin
n=15 Participants
Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group.
Control Group: Placebo
n=14 Participants
Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group on cognitive function (Brief Visuospatial Memory test-Revised (BVMT-R)).
Control Group: Insulin
n=14 Participants
Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group on cognitive function (Brief Visuospatial Memory test-Revised (BVMT-R)).
Cognitive Outcome: Brief Visuospatial Spatial Memory Test -Total Recall (Unit T Score)
39.46 T-score
Standard Deviation 8.86
41.23 T-score
Standard Deviation 9.85
43.1 T-score
Standard Deviation 17.29
50.9 T-score
Standard Deviation 9.66

PRIMARY outcome

Timeframe: Acute changes within 2 hours

To determine the acute effects of a single 40-IU dose of intranasal insulin vs. placebo on cognition and regional perfusion and vasoreactivity to CO2 challenge measured by 3-D continuous arterial spin labeling (CASL) MRI at 3 Tesla in the control and diabetic groups. Cognitive outcome: Brief Visuospatial Spatial Memory test -Total Recall (unit T Score). Perfusion outcome: Regional vasoreactivity (ml/100g/min/mmHg).

Outcome measures

Outcome measures
Measure
Diabetes Group: Placebo
n=15 Participants
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group on cognitive function (Brief Visuospatial Memory test-Revised (BVMT-R)).
Diabetes Group: Insulin
n=15 Participants
Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group.
Control Group: Placebo
n=14 Participants
Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group on cognitive function (Brief Visuospatial Memory test-Revised (BVMT-R)).
Control Group: Insulin
n=14 Participants
Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the control group on cognitive function (Brief Visuospatial Memory test-Revised (BVMT-R)).
Perfusion Outcome: Right Insular Cortex Perfusion (ml/100g/Min/mmHg)
39.2 ml/100g/min/mmHg
Standard Deviation 3.3
46.4 ml/100g/min/mmHg
Standard Deviation 3.6
40.3 ml/100g/min/mmHg
Standard Deviation 2.4
36.9 ml/100g/min/mmHg
Standard Deviation 2.5

Adverse Events

Diabetes Group: Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Diabetes Group: Insulin

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Group: Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Group: Insulin

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Diabetes Group: Placebo
n=15 participants at risk
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the non-diabetic control group. The intranasal administration of insulin was safe, with no serious adverse events or hypoglycemic episodes and the protocol was feasible for participants.
Diabetes Group: Insulin
n=15 participants at risk
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the non-diabetic control group. The intranasal administration of insulin was safe, with no serious adverse events or hypoglycemic episodes and the protocol was feasible for participants.
Control Group: Placebo
n=15 participants at risk
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the non-diabetic control group. The intranasal administration of insulin was safe, with no serious adverse events or hypoglycemic episodes and the protocol was feasible for participants.
Control Group: Insulin
n=15 participants at risk
Comparisons of acute effects of intranasal insulin or placebo on cerebral blood flow and cognition. Intranasal insulin: The acute effects of a single 40-IU dose of intranasal insulin vs. placebo in type 2 diabetes and the non-diabetic control group. The intranasal administration of insulin was safe, with no serious adverse events or hypoglycemic episodes and the protocol was feasible for participants.
Cardiac disorders
Hypertension
0.00%
0/15
0.00%
0/15
0.00%
0/15
6.7%
1/15 • Number of events 1

Additional Information

Dr. Vera Novak

Beth Israel Deaconess Medical Center

Phone: 617-632-8680

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place