Effect of Physiologic Insulin Administration on Cognition

Pennington Biomedical Research Center

Status: Completed

Conditions: Alzheimer Disease

Treatments: Other: Hyperinsulinemic Euglycemic Clamp Technique Insulin Sensitivity test; Other: Resting Metabolic Rate (RMR); Other: Blood draws

Study type: Interventional

Funder types: Other

Identifiers

NCT06424652

PBRC 2024-014

Details and patient eligibility

About

In humans, insulin is secreted in pulses from the pancreatic beta-cells, and these oscillations help to maintain fasting plasma glucose levels within a narrow normal range. These pulses become disrupted in the presence of insulin resistance. Some people have referred to Alzheimer's Disease as type 3 diabetes because the glucose uptake in the brain is reduced by 30%. Clinical observations in clinics that treat patients with insulin pulses every 5 minutes for 3 hours twice a week for 2 weeks followed by once a week for 6 weeks and followed by less frequency treatments suggest an improvement in type 2 diabetes control, reduction in insulin resistance and an improvement in diabetes complications. A patient with Parkinson's Disease was treated with this pulsed insulin paradigm and experienced dramatic improvement that has now been maintained over years. Parkinson's Disease has been reported to have a decreased glucose uptake in the brain, so pulsed insulin treatment was tried in a small number of patients with Alzheimer's Disease and there was an impression that they showed improvement. Clinics that use pulsed insulin treatment change more than one parameter of the insulin pulses which makes it difficult to determine what is giving the improvement. The euglycemic hyper-insulinemic clamp, also called a clamp, is a well-standardized test that measures insulin resistance and involves intravenous insulin infusion. This single patient study will enroll one patient with early Alzheimer's disease and insulin resistance. The subject will have one standard clamp test with continuous insulin followed by 4 clamps over a 2-week period using the same amount of insulin over the same period of time but administered in pulses every 5 minutes. This was the number of pulsed insulin treatments needed to see a dramatic improvement in Parkinson's disease. The cognition in the Alzheimer's disease patient will be thoroughly evaluated with questionnaires and walking on a special mat while doing arithmetic tasks before and after the 4 pulsed insulin clamps. If this study demonstrates an improvement in cognition, one will know that the only thing that changed from the standard clamp was the pulse nature of the insulin delivery.

Full description

The purpose of this research study is to test the effect of an insulin treatment on Alzheimer's disease.

Enrollment: 1 patient

Sex: Male

Ages: 65 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Early Alzheimer's Disease
• Insulin Resistance

Exclusion criteria

• Inability to walk
• Unable to read, understand or inability to complete questionnaire
• Belong to a vulnerable group like prisoners

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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1 participants in 1 patient group

Single Participant with Evidence of cognitive impairment.

Other group

Treatment:

Other: Blood draws

Other: Resting Metabolic Rate (RMR)

Other: Hyperinsulinemic Euglycemic Clamp Technique Insulin Sensitivity test