Does anyone have experience or perspective on intranasal insulin?

#1

I got curious about the use of insulin applied intranasally. Does anyone have experience? I got interested in the subject because I read a headline that intranasal insulin was showing efficacy restoring smell in long-covid patients. I also read that the olfactory bulb has the highest concentration of insulin receptors in the brain. Meanwhile, there is more and more science implicating Type 2 Diabetes and compromised insulin insensitivity in neurodegenerative disease.

I’m interested for myself because I have had a compromised sense of smell for at least the last 20 years and I have a unusual form of diabetes where I produce insufficient insulin. I’m thinking that I could use restored sense of smell as an endpoint in my one-man lab experiment.

Incidentally, I’m not planning to snort insulin. I would get a proper device for dosing and application and have my doctor prescribe it.

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Intranasal delivery of rapamycin via brain-targeting polymeric micelles for Alzheimer’s disease treatment (or prevention)
#2

I’m replying to my own post with some interesting info that I gathered on the subject. I’m also providing a little back story on my personal condition and throwing out some props to Dr Alan Green for making an insightful diagnosis that was under my nose (no pun intended) for many years.

It turns out that there is a cottage industry of medical device makers who design products for delivering medications intranasally. As best as I can tell the mack daddy of these devices is the ViaNase from Kurve Therapeutics. This device facilitates dosing, pressurization, precise atomization, etc. It makes it easy for a patient to deliver a consistent dose, taking into consideration the volume, viscosity, etc. of the medication.

Check out Kurve Therapeutics: www.kurvetx.com

I learned of this device from a researcher at Harvard Med who did a bunch of studies on intranasal insulin (INI) using this device. I had been reading up on the use of INI for treating smell disorders, but it turns out that there has been a lot of research on using INI to treat and even prevent neurodegenerative disease.

Punchline: Those of you trying to live forever might want to consider INI as part of your protocol.

Parenthetically, if any of you are interested in spraying Rapamycin up your nose or running a study on intranasal Rapamycin, you might inquire about using one of these devices for such a purpose.

ViaNase has been under development for many years, but Kurve has not yet completed a Phase 3 trial and thus they do not have FDA approval for any specific therapy. The product is, however, available through a compassionate use program. Apparently, a lot of the patients in the trials wanted to continue therapy afterwards, so Kurve made arrangements with the FDA under compassionate use. If you want to buy one of these devices, you will need a prescription from a licensed doctor. The device is also costly. I don’t think it is appropriate to post their price here, but suffice to say that it is a mid 5 figure spend in USD.

Back story: How I got interested in Intranasal Insulin
I have a funny form of Type 2 Diabetes that is caused by low insulin production, not by poor insulin sensitivity. My hypoinsulinemia is not caused by an autoimmune response, so it is not Type 1 or LADA (Type 1.5). It is also not one of the known monogenic diabetes. Some might argue that this condition should not be called Type 2 Diabetes since T2D is characterized by increasing poor insulin sensitivity, but this diagnosis makes sense to my insurance company, so I’m not arguing semantics.

By the way, kudos to Dr Alan Green for diagnosing this for me. I have known of my high blood sugar for years, but did not know I had this funky condition. As part of my consultation for Rapamycin therapy, Dr Green required me to get a fasting insulin and glucose test which revealed that I have very low insulin levels relative to glucose. These two values together produce a score called HOMA-IR which is a measurement of relative insulin sensitivity. So, it turns out that all of those years of low carb diet and intense exercise gave me good insulin sensitivity, but was not enough to keep my blood sugar at a healthy level.

(BTW, I’m using Ozempic and Acarbose to keep blood sugar in check. That’s a great combo for any of you out there struggling with high blood sugar.)

While it is imaginable that low insulin production could be good for longevity, both my father and grandfather died in their early 80s of Alzheimer’s, so I worry that low insulin could be implicated in their neurological disease. There has been a ton of research in the last few years implicating faulty glucose metabolism in neurodegenerative disease. There are even some labeling Alzheimer’s as Type 3 Diabetes.

Then, last month I saw a headline about intranasal insulin being used to treat smell disorders in long Covid patients. As it turns out, I have a compromised sense of smell for as long as I can remember. I wonder whether low insulin could be the cause and/or whether INI therapy might ameliorate. That kicked off this particular research thread, and now I’m excited to research another interesting biohack that might be relevant to cheating death. Hopefully, some of you will jump in on this with me or have experiences of your own to share.

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#3

Hello Jacob F, I came across this old post of yours because I searched "monogenic diabetes. You and I have shared information before.

First, I share your concern about low insulin. Mine is also low. My grandmother, aunt and mother had or have Alzheimers. They lived very long lives but were in an advanced stage for about ten years before they died. I have also read research that documents an association between low insulin and neurocognitive decline.

Together with the low insulin I have had pre-diabetes blood glucose levels going back at least a decade. I recently saw an endcrinologist. He said that I should do a OGTT and if it came back high he would test for monogenic diabetes. So, the FBG before the challenge was 89, and two hours after it was 155. So the endocrinologist dismissed me" you barely meet the criteria for impaired glucose tolerance. No treatment needed."

But I researched monogenic diabetes and came upon a very rare form called GCK -Mody. This is a genetically caused down-regulation of glucokinase, leading to impaired glucose sensing, thus causing too low a release of insulin. Blood glucose is usually in the predabetic range and tends to stay there, not progressing much or at all over time.

I felt that this fits my profile quite well and I consider it to be good news as it does not usually progress. There is no therapy. Diet has no impact. I have been on metformin and don’t think it has had any impact and my understanding is that metformin does not have any impact on GCK - MODY.

GCK Mody is rarely recognized, diagnosed, tested for. None of my doctors has mentioned it to me. But, that’s what I think I’ve got.

If you know anything about this particular rare form of monogenic diabetes, would appreciate any information or pointers . . .

#4

This is an interesting idea. Would avoid the destruction of most of the rapamycin in the gut, and might help penetrate the blood brain barrier.

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#5

We likely have similar conditions. I get it that you are anxious to know what the cause is, but you might find that elusive and it might not tell you anything. For me, it was helpful to know that no amount of exercise or diet management was going to work for me, so I started focusing on medication.

I did whole genome sequencing at sequencing.com, and they have an option to analyze the genome for monogenic diabetes. I came up negative. I’m pretty sure that they have the GCK-MODY screen.

I have consulted diabetes specialists who readily admit that there are many, many causes of diabetes and medical science does not really bother to unravel them. Most unapologetically don’t bother testing fasting insulin because it does not change for them how they treat the condition.

Here’s what I’m doing in the hopes that it avoids the Alzheimer’s fate that my father and his father experienced:

  • Mounjaro
  • Intranasal insulin – I bought a device from Kurve therapeutics that atomizes insulin and blows it up the nose. This has been demonstrated to be safe and to have some benefits for Alzheimer’s patients. The guy who founded the company asserts that it probably protects against Alzheimer’s. The device costs a few $thousand and requires a prescription from a licensed doctor. I figure that if I have low insulin production my brain probably has low insulin too. Maybe this helps. Shot in the dark.
  • I take Acarbose for big carb meals. This drug is super cheap. Plenty of other info on this web site.
  • I take fiber supplements in modest amounts – psyllium husk, konjac, inulin.

I am curious about Harmin. I have not made an effort to try it yet. I’m not inclined to buy it from a non pharmaceutical source.

I am also interested in the next generation of GLP-1 drugs that will also include an agonist for the glucagon receptor.

I have started researching Oxytocin and at some point I will probably try intranasal oxytocin to see if that helps my condition at all. Recent research shows that Oxytocin is involved in metabolism and plays a role in insulin production.

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#6

It has been a while since we exchanged information. I have been using intranasal insulin for several months. It has definitely decreased appetite: not as much as semaglutide (rybelsus) but does not have the negative sides of semaglutide. Cannot really tell if it has had any effect on cognition, but has definitely impacted brain signaling with respect to satiety/appetite.

I have been using the snoot bottles and am considering the vianase but was quoted $5000.

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#7

I splurged and bought the Vianase. My concern was for how to control dosing and ensure drug delivery with a conventional snoot-like bottle. Of course, it might not matter. The snoot might work fine.

I have not been able to detect any changes in blood sugar, hunger, cognition. I figure it is either doing something or not, but I honestly have no idea. It’s interesting that you are feeling something.

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#8

Update: have been using IN insulin for about eight months now. Continue to experience satiety benefits – not sure if it is from the continued use of the insulin, or just having now habituated myself to less intake. I can’t tell if it has had any impact on my husband: his appetite and interest in food has declined, but most probably the “natural” consequence of aging.

I would like to purchase the Vianase. Would appreciate any pointers on how you purchased yours.

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#9

Hi, Deborah. The company who makes the product is Kurve Therapeutics. www.kurvetx.com. The CEO is a guy named Marc Giroux. His first initial and last name makes up his email address at kurvetx.com. You will need a prescription from a licensed doctor to buy the device. You can then buy insulin at Walmart.

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#10

I cant say about nasal insulin but I recall I was remotely involved in an inhaled insulin trial almost 20 years ago. Pfizer pulled the plug on it as there was some concern regarding lung tumors.

#11

Yes there was an inhaled insulin product called Afrezza. But the inhaled insulin goes into the peripheral nervous system. Intra nasal insulin is targeted directly into the central nervous system via the trigeminal and olfactory nerve channels.

#12

Hello Jacob_F - searching the topic of INI for loss of smell plus delivery devices landed me at your post…

I’m wondering, has your sense of smell improved with your own INI experiment? (Detail welcomed.)

My own case is: sudden all-but-total loss of smell in 2020 (yes, everyone always asks “covid?” – I had no known symptom, and never tested positive, though that doesn’t “prove” I never had covid)…but the more significant circumstances have always seemed to me to be the 2 weeks spent in wildfire-polluted poor air that blanketed our area. After the air finally cleared, I noticed that my previously stellar sense of smell was missing, with occasionally distorted or phantom odors. Now & then I get all excited when I peel an orange and, for a second, sniff a far-away, very thin slice of citrus-scent, but primarily all smell is just emptiness… ENT visits, and all the etc. things I’ve tried find no cause, have no help.

I’m not diabetic, btw; pursuing info on INI because of the small studies on smell loss, where it appears to have possibly olfactory-capacity-reviving promise.

Long note for short question: any luck with the INI and sense of smell?

#13

I did not notice a change with the intranasal insulin, but I also did not do it scientifically. I will organize myself to try again at some point. I also keep meaning to methodically try smell retraining (see below), but I’ve just not made a project of it and committed myself.

Some thoughts:

The most likely explanation for your situation is Covid, but it is certainly possible that some other environmental insult caused it. Have you consulted an ENT? An ENT would start by administering the U Penn Smell Test: University of Pennsylvania Smell Identification Test - Wikipedia

This is a self-administered test, so you can buy it yourself.

The first thing to try is smell retraining, which just involves sniffing scented oils. You can buy kits of these on Amazon or you can buy applicators and oils separately. I have the following notes on the protocol, but I’m not sure where I got these. I’m guessing I cut and pasted from a scientific paper:

Olfactory Training

Olfactory training is a simple, structured program of smelling various scents, commonly lemon, rose, clove, and eucalyptus, in the form of essential oils. Scientists think that OT reorganizes the nerve connections in the brain through a process known as neuroplasticity, although the exact mechanism of action is unclear. The patient is instructed to hold the scent to their nose and slowly breathe in and out for 15 to 20 seconds. The patient rotates the 4 scents with a short, 10-second break in between and does this twice per day for at least 3 to 6 months. While sniffing, the patient is instructed to focus on the memory of the smell, and it is believed that through this process the patient will retrain the brain to smell. The important part is that the patient recognizes the scents so they can focus on the memory of the smell. At 1 to 3 months, the odors can be changed (for example, menthol, thyme, tangerine, and jasmine; or green tea, bergamot, rosemary, and gardenia). A patient can also increase the number of scents they practice with. Studies suggest improved sense of smell in patients suffering from viral olfactory loss as well as after trauma and other causes. The use of a nasal saline irrigation (neti pot or squeeze bottle) with a topical steroid medication may result in a less inflamed nasal environment for the smell nerves to regrow and can improve the overall effectiveness of OT.

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#14

"Over the course of the clinical trial program, 6 of the 4,740 Exubera-treated patients versus 1 of the 4,292 patients not treated with Exubera developed lung cancer. In addition there was a post-marketing report of lung cancer in one Exubera-treated patient. The update to the labeling states that all patients who developed lung cancer had a prior history of cigarette smoking, and that there were too few cases to determine whether the development of lung cancer is related to the use of Exubera".

Ref

“Pfizer stopped marketing and producing Exubera in October 2007 due to poor sales and lack of adoption by patients and physicians.”

The only inhaled insulin still on the market (as of 2025) is Afrezza, made by MannKind Corporation, not Pfizer.

Affrezza is available from India. Not cheap even from India. US prices with a prescription using GoodRx is expensive.

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#15

Thanks so much for your detailed response, Jacob_F! Very kind of you to share all that.

Yes, I did get some nasal imaging (no obstruction, no apparent cause), and also saw an ENT; his only input was a shrug (and a bill.) Like you, I’ve informally taken a few stabs at smell retraining. Might go at it again, more methodically as well.

If I get to try out intranasal insulin, I’ll report back!

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