TABLE 1.
Comparison of systemic versus intranasal delivery of insulin in treatment of TBI, SCI, AD and PD.
|
Systemic Insulin Administration |
Intranasal Insulin Administration |
|||||||
| Positive effects | Ref. # | Negative effects | Ref. # | Positive effects | Ref. # | Negative effects | Ref. # | |
| Traumatic Brain Injury | Improved neurological outcomes | van den Berghe et al., 2001; Oddo et al., 2008; Yang Y. G. et al., 2009) | Risk of hypoglycemia Increased mortality rate | van den Berghe et al., 2001; Bilotta et al., 2008; Yang Y. G. et al., 2009a; Vespa et al., 2012 Bilotta et al., 2008; Oddo et al., 2008; Investigators et al., 2009; Vespa et al., 2012; Hermanides et al., 2018 | Increased glucose uptake Improved cognitive function Reduced inflammation | Brabazon et al., 2017 Brabazon et al., 2017 Beirami et al., 2017; Brabazon et al., 2017 | N/A | |
| Spinal Cord Injury | Improved motor function in animal models Reduced apoptosis in spinal cord in animal models Reduced inflammation in spinal cord in animal models | Nagamizo et al., 2007; Wu et al., 2007; Yang Y. G. et al., 2009) Wu et al., 2007; Yang Y. G. et al., 2009) Wu et al., 2007 | Hyperglycemia from exogenous administration causing pro-inflammatory state Insulin may not produce sufficient response Insulin resistance | Prakash and Matta, 2008; Torabi et al., 2018 Duckworth et al., 1980 Duckworth et al., 1980 | N/A | N/A | ||
| Alzheimer’s disease | Improved memory | Craft et al., 1996 | Risk of hypoglycemia Insulin resistance | Craft et al., 1996 Zhong et al., 2012; Lutski et al., 2017 | Reduced amyloid beta levels, repaired insulin signaling, alleviated cognitive deficits in animal models No hypoglycemia Improved cognition and working memory Improved delayed verbal and story recall task performances | Chen et al., 2014; Salameh et al., 2015; Mao et al., 2016; Guo et al., 2017 Hanson and Frey, 2008 Hanson and Frey, 2008; Reger et al., 2008; Claxton et al., 2015 Reger et al., 2006; Craft et al., 2012, 2017 | Varied efficacy dependent on genotype | Craft et al., 2000, 2003 |
| Parkinson’s disease | N/A | N/A | Alleviated motor deficits in animal model No impact on blood glucose levels and quickly detectable in CSF Increased verbal fluency Lowered disability scores Improved motor function | Pang et al., 2016; Fine et al., 2020 Pang et al., 2016 Novak et al., 2019 Novak et al., 2019 Novak et al., 2019 | N/A | |||