# Lowering the Impact of Food insecurity in African American Adults with Type 2 Diabetes Mellitus (LIFT-DM) - Diversity Supplement

> **NIH NIH R01** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $41,666

## Abstract

Diabetes is the leading cause of chronic kidney disease (CKD) and end stage renal disease (ESRD). Thirty-
seven percent of adults with diagnosed diabetes have CKD, defined as the presence of elevated urine albumin-
to-creatinine ratio, impaired glomerular filtration rate or both. Diabetes disproportionately affects African
Americans, with a total prevalence of 16.4% among African Americans compared to 11.9% among Non-Hispanic
Whites. African Americans with diabetes have a 22% higher risk of developing CKD and are 3 times more likely
to progress to ESRD compared with Non-Hispanic Whites with diabetes. Multidimensional adversity or
disadvantage is a phenomenon that describes the variety of factors related to poverty, such as having both
socioeconomic and neighborhood disadvantage. In this proposal, multidimensional adversity refers to the
coexistence of food insecurity, and a variety of other adverse circumstances including housing instability,
adverse childhood experiences, transportation needs, utility needs and interpersonal safety. There is growing
evidence that having a single adversity such as food insecurity, adverse childhood experiences, or financial
hardship negatively impacts disease outcomes in individuals with diabetes or kidney disease; however, there is
limited understanding on the cumulative impact of these adversities (i.e. multidimensional adversity) on health
outcomes. Also, there is limited information on the lived experience of African American adults living with
diabetes and CKD who are also food insecure. This study will address a number of gaps in our current knowledge
in food insecure African Americans with type 2 diabetes by 1) evaluating the incremental effect of
multidimensional adversity on clinical outcomes (glycemic control, blood pressure, and cholesterol) and whether
it differs by CKD status, 2) evaluating the incremental effect of multidimensional adversity on self-care behaviors
(diet, physical activity, and medication adherence), and whether it differs by CKD status, and 3) conducting focus
groups to identify essential components of an intervention to address multidimensional adversity in a population
of food insecure African Americans with type 2 diabetes and CKD. For this diversity supplement, blood for basic
metabolic panel and eGFR estimation and urine for microalbumin/proteinuria will be added to baseline data
collection for the parent R01 and will be used to classify participants as having CKD. Then, using baseline data
from the parent study and additional focus groups from enrolled participants in the parent R01, this mixed
methods study will examine the relationship between multidimensional adversity and chronic kidney disease
(CKD) in food insecure African American adults with diabetes and CKD. This supplement will provide preliminary
data for a future culturally tailored intervention focused on African Americans with diabetes and CKD
experiencing multidimensional adversity. The supplement will also prov...

## Key facts

- **NIH application ID:** 10153578
- **Project number:** 3R01MD013826-02S1
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Leonard E. Egede
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $41,666
- **Award type:** 3
- **Project period:** 2019-05-03 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10153578

## Citation

> US National Institutes of Health, RePORTER application 10153578, Lowering the Impact of Food insecurity in African American Adults with Type 2 Diabetes Mellitus (LIFT-DM) - Diversity Supplement (3R01MD013826-02S1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10153578. Licensed CC0.

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