Get Healthy!

• Posted October 21, 2025

Diabetes Drugs Might Counter Brain Decline In Early Alzheimer's Patients

Two widely available diabetes medications appear to safely improve brain health among people with early brain decline.

The diabetes drug empagliflozin (Jardiance) and an insulin nasal spray both showed promising effects on memory, brain health and blood flow to the brain, researchers recently reported in the journal Alzheimer’s & Dementia.

“Our study suggests that targeting metabolism can change the course of Alzheimer’s disease,” said senior researcher Suzanne Craft, director of the Wake Forest Alzheimer’s Disease Research Center in Winston-Salem, North Carolina.

“For the first time, we found that empagliflozin, an established diabetes and heart medication, reduced markers of brain injury while restoring blood flow in critical brain regions,” she said in a news release.

“We also confirmed that delivering insulin directly to the brain with a newly validated device enhances cognition, neurovascular health and immune function,” Craft added. “Together, these findings highlight metabolism as a powerful new frontier in Alzheimer’s treatment.”

If validated, these results could address a critical treatment gap in people with Alzheimer’s disease.

Recently approved drugs that clear toxic amyloid proteins from the brain represent progress, but their benefits are modest, researchers noted.

Many patients can’t take anti-amyloids due to side effects, and the drugs also don’t address the metabolic and blood vessel problems that are contributing to brain decline, researchers added.

For the new trial, researchers recruited 47 seniors with an average age of 70, all of whom had either mild cognitive impairment or early Alzheimer’s.

The participants were randomly assigned to take insulin nasal sprays, empagliflozin, both medications together or a placebo drug.

Empagliflozin belongs to a class of drugs called SGLT2 inhibitors, which work by preventing the absorption of blood sugar in the kidneys. Instead, excess blood sugar is excreted in urine, helping lower blood sugar levels.

Results showed that both drugs were safe for the patients, with 97% sticking to their assigned regimen through the four-week trial.

However, the drugs showed different benefits.

Insulin nasal spray improved performance on tests that detect early memory and thinking changes, researchers reported. Scans showed that insulin increased the structural integrity of the white matter that connects different regions of the brain and improved blood flow in memory-critical regions.

Meanwhile, empagliflozin significantly lowered levels of tau, another toxic protein related to Alzheimer’s. The drug also reduced neurochemical and blood vessel markers linked to disease progression, changed blood flow in key brain regions and increased levels of “good” HDL cholesterol.

Overall, the changes caused by both drugs suggest that they help activate protective immune responses and reduce harmful inflammation, both of which might support brain health.

People with Alzheimer’s disease often have insulin resistance in their brains, along with blood vessel problems that limit the flow of oxygen and nutrients to brain cells.

These disruptions also can speed up the accumulation of amyloid plaques and tau tangles, while preventing the brain from clearing the toxic proteins.

“We plan to build on these promising results with larger, longer studies in people with early and preclinical Alzheimer’s disease,” Craft said. “Because empagliflozin or intranasal insulin improved tau tangles, cognition, neurovascular health and immune function, we believe these treatments could offer real therapeutic potential, either on their own or in combination with other Alzheimer’s therapies.”

Because both drugs are already approved by the U.S. Food and Drug Administration (FDA) for diabetes and other conditions, they could reach patients with declining brain health faster than brand-new drugs would, researchers added.

More information

The National Institutes of Health has more on dementia due to metabolic causes.

SOURCES: Wake Forest University, news release, Oct. 16, 2025; Alzheimer’s & Dementia, Oct. 7, 2025