{
  "abstract": "Background: This study analyzed the data from a previous randomized clinical trial to investigate the effects of intranasal insulin on postoperative delirium (POD) in older patients with and without type 2 diabetes mellitus (T2DM).\n\nMaterials and methods: This study included 128 older surgical patients, stratified into diabetes mellitus (DM, n = 50) and non-diabetes (Non-DM, n = 78) cohorts. Patients received either perioperative intranasal insulin or saline. The primary outcome was POD incidence; secondary outcomes included the perioperative changes Mini-Mental Status Examination (MMSE) scores and the Montreal Cognitive Assessment-Basic (MoCA-B) scores. Logistic and linear regression models were used to evaluate the association between intranasal insulin and outcomes within each subgroup. Additionally, sensitivity analyses adjusting for different covariates were performed to evaluate the consistency.\n\nResults: The incidences of POD in Group DM-S (DM + saline, n = 22), Group DM-I (DM + insulin, n = 28), Group Non-DM-S (non-DM + saline, n = 42), Group Non-DM-I (non-DM + insulin, n = 36) were 36.4%, 10.7%, 19% and 11.1%, respectively. Intranasal insulin was associated with reduced POD risk in T2DM patients (adjusted OR = 0.195, 95% CI: 0.036–0.826, P = 0.035), but not significant in non-T2DM patients. Additionally, insulin positively correlated with perioperative changes of MMSE and MoCA-B scores in both T2DM (MMSE: β = 1.042, 95% CI: 0.230–1.854, P = 0.013; MoCA-B: β = 1.093, 95% CI: 0.013–2.173, P = 0.047) and non-T2DM cohorts (MMSE: β = 0.748, 95% CI: 0.124–1.373, P = 0.019; MoCA-B: β = 0.887, 95% CI: 0.116–1.658, P = 0.025). Sensitivity analyses yielded consistent trends.\n\nConclusion: Intranasal insulin was associated with reduced POD incidence in older patients with T2DM and exhibited a potential protective effect on postoperative cognition.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40520-026-03459-4.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730 China",
    "Department of Anesthesiology, Tongji University, Shanghai, 200092 China",
    "Department of Oncology, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, 121001 China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Danyang Geng"
    },
    {
      "affs": [
        1
      ],
      "name": "Xianghan Ruan"
    },
    {
      "affs": [
        0
      ],
      "name": "Huikai Yang"
    },
    {
      "affs": [
        2
      ],
      "name": "Lulu Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "Mengyao Qu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanan He"
    },
    {
      "affs": [
        0
      ],
      "name": "Yan Tian"
    },
    {
      "affs": [
        0
      ],
      "name": "Yulong Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Weidong Mi"
    },
    {
      "affs": [
        0
      ],
      "name": "Miao Sun"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/aehep9cnpmxzc.bib",
  "cited_by": 0,
  "doi": "10.1007/s40520-026-03459-4",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13713991/",
  "id": "aehep9cnpmxzc",
  "issns": [
    "1594-0667",
    "1720-8319"
  ],
  "landing_url": "https://doi.org/10.1007/s40520-026-03459-4",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2706|Intensive Care Unit Cognitive Disorders"
    ]
  ],
  "openalex": "W7172140694",
  "pdf_url": null,
  "pmcid": "PMC13713991",
  "pmid": "42946938",
  "published": "2026-08-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/aehep9cnpmxzc.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:21:34Z",
      "native_id": "PMC13713991",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s40520-026-03459-4"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2706|Intensive Care Unit Cognitive Disorders",
      "subfield": "general"
    }
  ],
  "title": "Effects of intranasal insulin on postoperative delirium in older patients with and without type 2 diabetes mellitus: a secondary analysis of a randomized clinical trial",
  "title_text": "Effects of intranasal insulin on postoperative delirium in older patients with and without type 2 diabetes mellitus: a secondary analysis of a randomized clinical trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:21:34Z",
  "url": "https://research.draconitic.com/paper/aehep9cnpmxzc",
  "venue": "Aging Clinical and Experimental Research",
  "versions": []
}