# Contributions of Hypoglycemia and Hyperglycemia to Adverse Geriatric Outcomes in NH Residents with Diabetes and Alzheimer's Disease and Related Dementias (ADRD)

> **NIH NIH K01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $131,963

## Abstract

Project Summary/Abstract
Nursing home (NH) residents with type 2 diabetes have substantial multimorbidity that complicates diabetes
management. Alzheimer's Disease and related dementias affects nearly 50% of NH residents and may
increase risk of hypoglycemia. Current NH diabetes management guidelines do not address Alzheimer's
Disease and related dementias and current recommendations for NH target blood glucose ranges are based
on expert opinion rather than evidence of adverse geriatric outcomes at certain thresholds of glycemia. To
address these weaknesses, we propose the following aims: 1) to compare the incidence rates of hypo- and
hyper-glycemia in the NH by dementia status, 2) to examine the acute effects of hypo- and hyper-glycemia on
geriatric syndromes and evaluate whether Alzheimer's Disease and related dementias modifies glycemic
thresholds, and 3) to examine the cumulative effects of hypo- and hyper-glycemia on cognitive decline and
functional decline, and to determine whether baseline severity of Alzheimer's Disease and related dementias
modifies glycemic thresholds. The proposed research leverages existing Veterans Affairs electronic health
record databases, a unique source of routine fingerstick glucose measurements. The long-term goal of this
research is to establish NH-specific target blood glucose ranges with thresholds of hypoglycemia and
hyperglycemia that account for the presence of Alzheimer's Disease and related dementias. Dr. Lee seeks a
K01 Mentored Research Scientist Development Award to obtain essential skills and mentored research
experience that will launch her career as an independent investigator in the field of aging, diabetes, and
Alzheimer's Disease and related dementias. The five-year training plan will fill content gaps in geriatric
syndromes and the assessment of Alzheimer's Disease and related dementias while building on her
methodological strengths to include advanced causal inference methods and using electronic health records
for research. Dr. Lee will complete the proposed research in the rich training environment of the UCSF Division
of Geriatrics, with primary mentorship from geriatrics health services researcher Dr. Sei Lee, MD, MAS,
Professor of Geriatrics at UCSF, co-mentorship by dementia expert Dr. Kristine Yaffe, MD, Professor of
Psychiatry, Neurology and Epidemiology at UCSF, and aging epidemiologist Dr. Michelle Odden, PhD,
Associate Professor of Epidemiology in the Division of Health Research and Policy at Stanford University. With
the support of her mentors, co-mentors, and esteemed advisors, Dr. Lee will advance towards successfully
competing for R01 funding and becoming a leader in geriatric diabetes.

## Key facts

- **NIH application ID:** 10477334
- **Project number:** 5K01AG073532-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Alexandra Kathryn Lee
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $131,963
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10477334

## Citation

> US National Institutes of Health, RePORTER application 10477334, Contributions of Hypoglycemia and Hyperglycemia to Adverse Geriatric Outcomes in NH Residents with Diabetes and Alzheimer's Disease and Related Dementias (ADRD) (5K01AG073532-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10477334. Licensed CC0.

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