# SOCRATES: SOCial Risk and diAbetes ouTcomEs Study

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $608,162

## Abstract

ABSTRACT
 Health-related social needs, particularly food insecurity, housing instability, and transportation barriers, are
associated with poor outcomes for people with type 2 diabetes mellitus (T2DM). In particular, these factors are
associated with worse glycemic, blood pressure, and LDL cholesterol control, which significantly increases the
risk of macrovascular and microvascular complications. They are also key drivers of racial/ethnic and
socioeconomic status-based disparities in diabetes outcomes. Thus, there is a growing call for interventions to
address these needs and improve T2DM outcomes. However little research has assessed whether changes in
health-related social needs are associated with changes in T2DM outcomes.
 This knowledge gap hampers efforts to develop effective interventions. Addressing it will provide much-
needed evidence on which patients to screen for which social needs, and on which interventions targeting
social needs are most likely to improve T2DM outcomes. The pathways linking social needs and T2DM
outcomes are likely characterized by interactions between individual- (e.g., needs, age, gender, race/ethnicity),
clinic- (e.g., clinic characteristics; specifics of the intervention), and area-level factors (e.g., local economic
conditions; community resources). Given this complexity, a multi-pronged approach is needed. We will
combine 3 methods of investigation: 1) longitudinal, multi-level, regression analysis; 2) innovative machine
learning methods to detect novel combinations of factors associated with heterogeneous response to health-
related social needs and health-related social needs interventions while avoiding spurious findings; and 3)
thoughtful qualitative investigation. Such an analysis has never before been possible, because the needed
data elements have not been united.
 This proposal seeks to answer whether improvements in specific health-related social needs are
associated with improvements in specific clinical outcomes, in what circumstances, and which approaches to
addressing health-related social needs, if any, best improve outcomes. We will leverage what we believe to be
the nation’s largest dataset of patient-reported health-related social needs, clinical outcomes, and community-
and clinic-level data. We will examine whether changes in health-related social needs are associated with
changes in hemoglobin A1c, systolic and diastolic blood pressure, and LDL cholesterol. Further, we will
evaluate whether clinic-based interventions seem to improve these outcomes, and if there are important
variations in these interventions that are associated with different response to the intervention. The proposed
work will yield important, previously unavailable evidence on how to refine and improve health-related social
need interventions. Specifically, it will help us understand better how better to care for a population at high risk
for T2DM complications. Overall, this project will substantially advance NIDDK’s ...

## Key facts

- **NIH application ID:** 10477298
- **Project number:** 5R01DK125406-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Seth A Berkowitz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $608,162
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10477298

## Citation

> US National Institutes of Health, RePORTER application 10477298, SOCRATES: SOCial Risk and diAbetes ouTcomEs Study (5R01DK125406-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10477298. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*