Intranasal Insulin to Treat Low Blood Sugar Unawareness

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Type 1 diabetes (T1D) can bring the fear of developing low blood sugar, called hypoglycemia, which can arise if someone takes too much insulin. But even more than that fear is the fear that a person with T1D or a caregiver won’t recognize the symptoms and take action (common treatments include glucose tablets or juice to bring the blood sugar back to normal range).

Unawareness of hypoglycemia accounts for a high number of emergency room visits by people with T1D. In very low blood sugar, a person can have difficulty speaking, can be confused and have blurred vision or, in rare cases, have seizures or enter into a coma.

However, there is evidence that insulin in the brain, taken through the nose to avoid low blood sugar (called intranasal insulin), can help. Clinical trials of people with Alzheimer’s disease have shown that intranasal insulin use can improve memory, attention and function. So JDRF has teamed up with the HealthPartners Institute’s International Diabetes Center (IDC), led by Anders Carlson, M.D., to find out if intranasal insulin can restore awareness to hypoglycemia in people with T1D who have known hypoglycemia unawareness.

In a clinical trial, investigators will take 26 people living with T1D, who will receive either intranasal insulin or placebo for four weeks, take six weeks off and cross over to the other treatment (intranasal insulin or placebo) for four weeks. If the researchers can demonstrate that insulin delivered to the brain can help restore awareness of low blood sugars, without causing any side effects or changes in the blood sugar in the rest of the body, it would be a major step forward to people with T1D and will help overcome a long-time barrier to optimized T1D management.

You can read more about this clinical trial in our press release.