Key Takeaways
- Diabetes drug empagliflozin and intranasal insulin spray show promise for early Alzheimer’s
- Both medications improved brain health, memory, and blood flow in clinical trial
- Treatments were safe and well-tolerated with mild side effects
Two commonly available medications – a diabetes drug and nasal insulin spray – have demonstrated significant potential to delay Alzheimer’s disease progression according to new research. The four-week clinical trial found both treatments safely improved brain health in patients with early Alzheimer’s or mild cognitive impairment.
Study Details and Promising Results
Researchers from Wake Forest University School of Medicine enrolled 47 older adults with an average age of 70. Participants received either intranasal insulin alone, empagliflozin alone, both medications together, or a placebo.
Both treatments were well-tolerated with mild side effects similar across all groups. Each medication provided distinct benefits:
- Insulin nasal spray improved performance on cognitive tests detecting early memory changes
- Empagliflozin (sold as Jardiance) reduced tau protein in spinal fluid, linked to toxic brain lumps in Alzheimer’s patients
How These Treatments Work
The nasal spray uses a precision device to deliver insulin directly to the brain via the nose, bypassing the bloodstream. Once in the brain, insulin activates proteins that maintain nerve health, support blood vessel function, and regulate immune responses.
Empagliflozin reduced markers of brain injury while restoring blood flow in critical brain regions. Both treatments appear to activate protective immune responses while reducing harmful inflammation.
“For the first time, we found that empagliflozin reduced markers of brain injury while restoring blood flow in critical brain regions,” said study author Suzanne Craft from Wake Forest University.
Addressing Treatment Gaps
These findings address a critical treatment gap for Alzheimer’s patients. While recently approved Alzheimer’s drugs represent progress, their benefits remain modest and they’re unavailable to many patients due to side effects.
Existing treatments also don’t address brain blood flow problems that drive Alzheimer’s progression or help restore brain function after damage occurs.
“Because empagliflozin or intranasal insulin improved tau tangles, cognition, neurovascular health and immune function, we believe these treatments could offer real therapeutic potential,” Dr. Craft added.
Researchers plan larger, longer studies to confirm these promising results. The study was published in the journal Alzheimer’s & Dementia.



