Skip to content
DraconiticResearch
Search Sources API
182,544 studies31 sourcesUpdated 44 min ago
Peer-reviewedCC BY-NC-ND 4.0Aging Clinical and Experimental Research

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

  • Danyang Geng1
  • Xianghan Ruan2
  • Huikai Yang1
  • Lulu Zhou3
  • Mengyao Qu1
  • Yanan He1
  • Yan Tian1
  • Yulong Ma1
  • Weidong Mi1
  • Miao Sun1
  1. 1Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100730 China
  2. 2Department of Anesthesiology, Tongji University, Shanghai, 200092 China
  3. 3Department of Oncology, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, 121001 China
Read full textDOICite

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).

Materials 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.

Results: 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.

Conclusion: Intranasal insulin was associated with reduced POD incidence in older patients with T2DM and exhibited a potential protective effect on postoperative cognition.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40520-026-03459-4.

Related

  1. Effects of multiple low-dose intranasal dexmedetomidine administration on postoperative pulmonary complications in elderly patients undergoing thoracoscopic radical resection of lung cancer: a single-center randomized controlled trial
    Bing Li, Yao Liu, Xinmin Liu +5
    Frontiers in pharmacologyPeer-reviewedCC BYFull textSurgery & anaesthesiaEurope PMCCrossref
  2. Commentary: Incidence and independent risk factors for postoperative delirium in ICU patients after cardiopulmonary bypass cardiac surgery: a retrospective cohort study
    Antonio Salsano, Francesco Santini
    Frontiers in Cardiovascular MedicinePeer-reviewedCC BY 4.0Cardiovascular medicineCrossref
  3. Serum NLRP3 levels are associated with postoperative delirium of elderly patients with lung cancer: an observational analytical study
    Yuanchao Cheng, Yuzhen Liu, Guanglin Tan +3
    Frontiers in neurologyPeer-reviewedCC BYFull textNeurologyEurope PMC
  4. Exploring the relationship between oral microbiome and postoperative delirium in patients with oral squamous cell carcinoma
    Shao Yu Hung, Kai-Ping Chang, Chia-Ling Chu +5
    Translational PsychiatryPeer-reviewedCC BY-NC-ND 4.0Psychiatry & mental healthCrossref
  5. Development and Validation of a Perioperative Risk Update Model for Postoperative Delirium in Patients Aged ≥ 80 Years Undergoing Hip Fracture Surgery: A Retrospective Cohort Study
    Feifei Zhao, Huan Sai, Shan Peng +4
    Clinics in orthopedic surgeryPeer-reviewedCC BY-NCFull textSurgery & anaesthesiaEurope PMC

Cite

BibTeXRIS
BibTeX
@article{geng2026effects,
  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}},
  author = {Danyang Geng and Xianghan Ruan and Huikai Yang and Lulu Zhou and Mengyao Qu and Yanan He and Yan Tian and Yulong Ma and Weidong Mi and Miao Sun},
  journal = {Aging Clinical and Experimental Research},
  year = {2026},
  month = aug,
  doi = {10.1007/s40520-026-03459-4},
  url = {https://doi.org/10.1007/s40520-026-03459-4},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - 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
AU  - Danyang Geng
AU  - Xianghan Ruan
AU  - Huikai Yang
AU  - Lulu Zhou
AU  - Mengyao Qu
AU  - Yanan He
AU  - Yan Tian
AU  - Yulong Ma
AU  - Weidong Mi
AU  - Miao Sun
PY  - 2026
DA  - 2026/08/01
JO  - Aging Clinical and Experimental Research
DO  - 10.1007/s40520-026-03459-4
UR  - https://doi.org/10.1007/s40520-026-03459-4
AB  - 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).  Materials 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.  Results: 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.  Conclusion: Intranasal insulin was associated with reduced POD incidence in older patients with T2DM and exhibited a potential protective effect on postoperative cognition.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40520-026-03459-4.
SN  - 1594-0667
SN  - 1720-8319
ER  -