The study hypothesizes that a year of consecutive treatment with inhaled insulin compared to a placebo group receiving no insulin, will yield increased cognition, increased memory, and increased daily functioning. The study will look at biomarkers in cerebrospinal fluid, and will also measure brain atrophy before and after the study. It includes 240 people with Alzheimer’s disease. For six months prior to the placebo trial, participants will all be given inhaled insulin. By using intranasal insulin, researchers know that they can get insulin straight to the brain, where it may do some good for these study patients. (6)
An intent-to-treat analysis revealed that inhaled nitric oxide at 5 ppm did not increase the number of days patients were alive and off assisted breathing (mean [SD],  days in the placebo group and  days in the inhaled nitric oxide group; P =.97; difference, - day [95% confidence interval, - to days]). This lack of effect on clinical outcomes was seen despite a statistically significant increase in PaO2 that resolved by 48 hours. Mortality was similar between groups (20% placebo vs 23% nitric oxide; P =.54). Days patients were alive following a successful 2-hour unassisted ventilation trial were a mean (SD) of () for placebo and () for nitric oxide patients (P =.54). Days alive and meeting criteria for extubation were also similar: placebo vs nitric oxide (P =.89).