# DFU Clinical Research Unit

> **NIH NIH U01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $388,652

## Abstract

ABSTRACT
The ongoing COVID-19 pandemic disproportionately affects type 2 diabetes (T2D) patients, who are especially
susceptible to SARS-CoV-2-induced adverse outcomes and complications. T2D patients have several
comorbidities that increases their vulnerability: obesity, chronic inflammation, and vascular complications, i.e.,
diabetic kidney disease (DKD), diabetic neuropathy (DN), and cardiovascular disease (CVD). T2D patients are
also predisposed to the cytokine storm syndrome (CSS), an acute inflammation state triggered by COVID-19.
CSS releases a cascade of inflammatory cytokines that causes dangerous hyperglycemic surges and
perpetuates a vicious cycle of cytokine release. Yet, there is a critical knowledge gap on how the initial CSS that
occurs with the onset of COVID-19 disease superimposes on chronic T2D inflammation to contribute to adverse
outcomes and what are the cytokines that most strongly predict the clinical course in COVID-19 T2D patients.
Given the T2D prevalence, high COVID-19 infection rate, and lack of therapies, there is an urgent unmet need
to identify risk-factors and inflammatory biomarker profiles that predict the most critical incoming COVID-19 T2D
cases to prepare us for the next pandemic wave.We also urgently need evidence-based guidelines for managing
complications in survivors from the first wave. Our objective is to establish the knowledge base needed to meet
this clinical need by developing risk-assessment tools to inform management of current COVID-19 T2D patients
and prepare for future waves. Our overall hypothesis is that acute inflammatory surges, secondary to SARS-
CoV-2-induced CSS, raise the risk of acute adverse outcomes and accelerate progression of chronic diabetic
complications. We will test this hypothesis in an ongoing cohort of ~500 severe COVID-19 patients admitted at
Michigan Medicine, of whom 208 have T2D. Known as the Michigan Medicine COVID-19 Cohort (M2C2, PI:
Hayek), clinical data and biosamples were collected on admission and throughout the hospital course. Our one-
year short term goals are to: (i) identify inflammatory signatures that correlate to inpatient outcomes in the M2C2,
(ii) deeply phenotype M2C2 participants 3-6 months post-hospitalization for chronic vascular complications (DKD,
DN, CVD), and longer term inflammatory signatures, (iii) assess the 3-6 month psychosocial outcomes of M2C2
participants. Our Specific Aims are:1) Identify an inflammatory biomarker signature linked to acute complications
in T2D M2C2 patients; b) Define the post-discharge clinical course by inflammatory biomarker signatures in T2D
M2C2 patients. Our proposed research will have immediate significant impact by generating the knowledge based
required for much needed, and immediately applicable clinical guidelines for managing current and future
COVID-19 T2D patients. It will also establish an informative biomarker panels that correlate with acute and
chronic T2D COVID-19 clinical phenotypes and inform outpat...

## Key facts

- **NIH application ID:** 10219889
- **Project number:** 3U01DK119083-03S1
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** RODICA BUSUI (POP-BUSUI)
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $388,652
- **Award type:** 3
- **Project period:** 2018-09-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10219889

## Citation

> US National Institutes of Health, RePORTER application 10219889, DFU Clinical Research Unit (3U01DK119083-03S1). Retrieved via AI Analytics 2026-06-08 from https://api.ai-analytics.org/grant/nih/10219889. Licensed CC0.

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