# Glucose Regulation and Cognitive Function in Type 2 Diabetes

> **NIH NIH P01** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2024 · $635,558

## Abstract

PROJECT ABSTRACT:
With our aging population and expanding obesity epidemic, the importance of type 2 diabetes
(T2D) as a remediable risk factor for cognitive decline has expanded, particularly in underserved
communities. T2D is a risk factor for Alzheimer’s disease and related dementias, vascular
dementia, mild cognitive impairment and accelerated cognitive decline. Despite abundant
evidence linking blood glucose (BG) control to cognitive outcomes, research has failed to show
that intensive treatment of diabetes reduces the risk of cognitive decline, perhaps due to
increased exposure to hypoglycemia and BG variability. Neither of these important aspects of
BG control are captured by standard measures. Similarly, prior research is limited by use of
conventional cognitive assessments, which are insensitive to cognitive change. We address
these limitations as part of the renewal of the Einstein Aging Study (EAS; NIA P01 AG003949)
with a new project that innovatively pairs continuous glucose monitoring (CGM) technology with
smartphone-based, ultra-brief, but highly sensitive ambulatory cognitive tests, developed and
validated in the previous funding period. Through annual 14-day measurement bursts we will
capture the dynamic relationships of BG levels and short-term cognitive variation in real time.
We will be better able to examine how BG regulation predicts cognitive decline over 5 years of
follow-up. The overarching aim of the proposed project is to examine the short- and long-term
effects of various clinically important BG parameters on cognitive performance and decline. The
study will enroll 230 racially and ethnically diverse, and predominantly socioeconomically
disadvantaged older adults age 60+ with T2D, systematically recruited from our Bronx
community. Potential bio-behavioral mediators of short-term effects on cognitive performance
include depression symptoms, negative affect, sleep and fatigue; moderators include age, sex,
race/ethnicity, amyloid, tau, inflammation, and vascular health. Candidate bio-behavioral
mechanisms for effects on long-term cognitive decline associations include depression,
negative affect, sleep, inflammation, elevation of AD biomarkers, and markers of vascular
disease. Moderators include age, sex, race/ethnicity, amyloid, Tau, inflammation, and vascular
health. This research will advance our understanding of the effects of T2D on cognitive
performance and decline in a racially and ethnically diverse at-risk population of older adults.
Ultimately, this work will facilitate the tailoring of glycemic goals and intervention strategies
based on individual patient characteristics.

## Key facts

- **NIH application ID:** 10857300
- **Project number:** 5P01AG003949-40
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Richard B. LIPTON
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $635,558
- **Award type:** 5
- **Project period:** 1982-09-29 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10857300

## Citation

> US National Institutes of Health, RePORTER application 10857300, Glucose Regulation and Cognitive Function in Type 2 Diabetes (5P01AG003949-40). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10857300. Licensed CC0.

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