# Personal and social-built environmental factors of glucose variability among multi ethnic groups of adults with type 2 diabetes

> **NIH NIH R01** · YALE UNIVERSITY · 2024 · $520,482

## Abstract

PROJECT SUMMARY
The pivotal goals of diabetes treatment are to minimize diabetes complications and improve quality of life for
individuals with diabetes. In-depth analyses from large scale, randomized trials and epidemiological studies
have indicated that glycated hemoglobin (HbA1c), the primary metric for assessing glycemic control, alone
may not sufficiently predict the risk of diabetes complications. Near-normal HbA1c level did not consistently
improve diabetes complications. People with similar HbA1c values can have markedly different glucose profiles
with varying frequencies and amplitudes of hypo- and hyper-glycemia. Glucose variability (GV) refers to
fluctuations in blood glucose levels throughout the day (intra-day GV) or over days (inter-day GV) and is an
emerging predictor of diabetes complications. GV can be measured in real-time through continuous glucose
monitoring (CGM). Considerable research in CGM to understand GV has led to the growing use of CGM in
clinical practice among individuals with type 1 diabetes. However, few studies address factors that affect GV in
type 2 diabetes (T2D), leaving large gaps in knowledge about how to mitigate GV and improve diabetes
outcomes in T2D. Roles of individuals’ lifestyle behaviors, emotional well-being and social-built environments
in glucose control have been well documented. Also, real-time data on lifestyle such as day-to-day sleep,
physical activity and diet are being generated. However, how these factors are associated with GV has yet to
be examined. This study will be one of the first to prospectively examine the temporal relationships among
sleep, physical activity, diet, emotional well-being, and GV, incorporating between-person associations and
within-person variability among adults of diverse race/ethnicity with T2D. We will use a real-time, data capture
strategy, ecological momentary assessment to measure lifestyle factors and emotional well-being. Three 24-hr
dietary recalls will be conducted to collect nutrient-level data. We will also use actigraphy as objective
measures of sleep and physical activity paired with CGM, a real-time, unobtrusive glucose measure that will be
blinded from participants during a study period of 14 days. The specific aims of the study are to: (1) identify risk
factors associated with high GV among diverse adults with T2D by examining between-person associations
among demographics, clinical factors, lifestyle (sleep, physical activity, diet) factors, the variability of each
lifestyle factor, emotional well-being, social-built environmental factors and inter-day GV, (2) identify ‘within-
person predictors’ of GV to inform the development of personalized diabetes interventions by examining within-
person associations among sleep, physical activity, diet, emotional well-being and intra-day GV, and (3)
examine which lifestyle factors either mediate or moderate the relationship between emotional well-being and
GV among diverse adults with T2D. The findings fro...

## Key facts

- **NIH application ID:** 10831526
- **Project number:** 5R01DK132069-03
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Soohyun Nam
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $520,482
- **Award type:** 5
- **Project period:** 2022-07-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10831526

## Citation

> US National Institutes of Health, RePORTER application 10831526, Personal and social-built environmental factors of glucose variability among multi ethnic groups of adults with type 2 diabetes (5R01DK132069-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10831526. Licensed CC0.

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