Clinical scientists at the Hotchkiss Brain Institute are starting the first pilot study looking at the delivery of insulin via the nasal passageway as a potential new treatment for diabetic neuropathy (DPN).

About 50 per cent of people with diabetes will develop DPN, a debilitating and painful nerve disease.  Current treatment is limited to pain management only.

Cory Toth, MD, fellow, Lawrence Korngut, MD, and colleagues, have demonstrated that intransal insulin helps protect nerves in the brain and central nervous sysem (cns) of mice.  It also slowed the progression of DPN and prolonged lifespan in comparison to subcutaneous insulin.  These findings were published earlier this year in the journals Brain and Diabetes.

Toth's research shows that nerves are deficient of insulin.  He estimates that only 2 per cent of subcutaneous insulin migrates to the brain and nerves, whereas, 98 per cent of aersolized insulin targets the brain and cns.  Intranasal administration permits insulin to bypass the blood-brain barrier reaching the brain and entering cerbrospinal fluid within minutes.

Targeting drugs to the brain using this method is not a new concept, however, this is the first time that researchers have tried using this approach for DPN treatment. 

Now, this research has been approved and funded for a small pilot trial involving 40 type 1 diabetics.  The pilot study is an important first step for moving this important translational work from the bench to the bedside.