ALSUntangled #72: Insulin

Andrew Brown; Carmel Armon; Paul Barkhaus; Morgan Beauchamp; Tulio Bertorini; Mark Bromberg; Javier Mascias Cadavid; Gregory T Carter; Jesse Crayle; Eva L Feldman; Terry Heiman-Patterson; Sartaj Jhooty; Alexandra Linares; Xiaoyan Li; Elise Mallon; Christopher Mcdermott; Tasnim Mushannen; George Nathaniel; Gary Pattee; Kaitlyn Pierce; Dylan Ratner; Lenka Slactova; Paul Wicks; Richard Bedlack

doi:10.1080/21678421.2023.2288110

ALSUntangled #72: Insulin

Amyotroph Lateral Scler Frontotemporal Degener. 2024 May;25(3-4):416-419. doi: 10.1080/21678421.2023.2288110. Epub 2023 Nov 28.

Authors

Andrew Brown¹, Carmel Armon², Paul Barkhaus³, Morgan Beauchamp⁴, Tulio Bertorini⁵, Mark Bromberg⁶, Javier Mascias Cadavid⁷, Gregory T Carter⁸, Jesse Crayle⁹, Eva L Feldman¹⁰, Terry Heiman-Patterson¹¹, Sartaj Jhooty¹², Alexandra Linares¹³, Xiaoyan Li¹⁴, Elise Mallon¹⁵, Christopher Mcdermott¹⁶, Tasnim Mushannen¹⁴, George Nathaniel¹⁵, Gary Pattee¹⁷, Kaitlyn Pierce¹⁸, Dylan Ratner¹⁹, Lenka Slactova²⁰, Paul Wicks²¹, Richard Bedlack¹⁴

Affiliations

¹ Department of Neurology, University of Miami, Miami, FL, USA.
² Department of Neurology, Loma Linda University Health, Loma Linda, CA, USA.
³ Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
⁴ UNC Health, UNC, Chapel Hill, NC, USA.
⁵ Neurology Department, University of Tennessee Health Science Center, Memphis, TN, USA.
⁶ Department of Neurology, University of Utah, Salt Lake City, UT, USA.
⁷ ALS Department, Hospital Carlos III-La Paz, Madrid, Spain.
⁸ Department of Rehabilitation, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
⁹ Department of Neurology, St. Louis, MO, USA.
¹⁰ Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
¹¹ Department of Neurology, Temple Health, Philadelphia, PA, USA.
¹² University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹³ Medical School, Duke University, Durham, NC, USA.
¹⁴ Department of Neurology, Duke University, Durham, NC, USA.
¹⁵ Undergraduate, Duke University, Durham, NC, USA.
¹⁶ Department of Neuroscience, University of Sheffield, Sheffield, South Yorkshire, UK.
¹⁷ Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA.
¹⁸ Department of Neuroscience, University of North Carolina, Chapel Hill, NC, USA.
¹⁹ Undergraduate, Tulane University, New Orleans, LA, USA.
²⁰ Institute of Biology and Medical Genetics, Charles University, Prague, Czech Republic, and.
²¹ Independent Consultant, Lichfield, England, UK.

PMID: 38018119
DOI: 10.1080/21678421.2023.2288110

Abstract

ALSUntangled reviews alternative and off-label treatments for people living with amyotrophic lateral sclerosis (PALS). Here we review insulin, which has at least one plausible mechanism for slowing ALS progression. However, pre-clinical studies are limited and there have been no trials in PALS yet. Insulin use in patients without a metabolic need may cause very serious and potentially lethal side effects. While further studies to evaluate potential benefits may be warranted, at this time we cannot endorse insulin treatment to slow ALS progression.

Keywords: Amyotrophic lateral sclerosis (ALS); insulin; metabolism; off-label treatment.

Publication types

Review

MeSH terms

Amyotrophic Lateral Sclerosis* / drug therapy
Humans
Insulin / adverse effects

Substances

Insulin