Intranasal Insulin and Postoperative Delirium in Diabetes: Exploratory Subgroup Signal
This post hoc subgroup analysis of a perioperative randomized trial suggests intranasal insulin may lower delirium risk in older adults with type 2 diabetes, but it cannot support clinical adoption.
📅 Journal publication: Aug 1, 2026·Last updated: Oct 28, 2026
Can intranasal insulin protect against postoperative delirium in older patients?
Postoperative delirium (POD) can lead to complications in older patients, particularly those with type 2 diabetes mellitus (T2DM). Intranasal insulin reduced POD incidence to 10.7% in T2DM patients compared to 36.4% with saline and improved cognitive scores in both groups. Preliminary findings suggest intranasal insulin may lower POD risk in T2DM patients, but more robust evidence is needed before practice changes. Intranasal insulin might reduce postoperative delirium in older patients with T2DM.
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Authors:Geng D, Ruan X, Yang H, Zhou L, Qu M, He Y, Tian Y, Ma Y, Mi W, Sun M
Citation:Geng D, Ruan X, Yang H, et al. 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. Aging clinical and experimental research. 2026;38(1). doi:10.1007/s40520-026-03459-4